Observational studyPediatric rheumatology online journal2015
Prediction of methotrexate intolerance in juvenile idiopathic arthritis: a prospective, observational cohort study.
Observational study in Pediatric rheumatology online journal, 2015. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT04169828 (The Ondansetron Premedication Trial in Juvenile Idiopathic Arthritis), which is not on this map. Cited by 26 papers, 2 of them syntheses that pooled it.
What it found
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The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
The Ondansetron Premedication Trial in Juvenile Idiopathic Arthritis
Who cites it
26 citing papers in PubMed, 2 syntheses or guidelines pooled it.
- The impact of gene polymorphisms on the response of methotrexate-based treatments.European journal of clinical pharmacology · 2026Pooled it
- Methotrexate for juvenile idiopathic arthritis.The Cochrane database of systematic reviews · 2024Pooled it
- Efforts towards a precision medicine approach in juvenile idiopathic arthritis.Rheumatology (Oxford, England) · 2026Review
- Methotrexate toxicity and intolerance in paediatric inflammatory bowel disease: A retrospective cohort study.Journal of pediatric gastroenterology and nutrition · 2026Article
- High prevalence of methotrexate intolerance in rheumatoid arthritis patients: a cross-sectional study.BMC rheumatology · 2025Article
- Duration of effect in treatment of methotrexate intolerance in juvenile idiopathic arthritis using Eye Movement Desensitization and Reprocessing (EMDR) can be improved by Bi-lateral Alternating Stimulation Tactile (BLAST) wristbands.Pediatric rheumatology online journal · 2024Article
- Methotrexate Intolerance in Juvenile Idiopathic Arthritis: Definition, Risks, and Management.Paediatric drugs · 2024Review
- The role of liver transaminase levels in methotrexate intolerance in juvenile idiopathic arthritis-a cross-sectional study.Rheumatology international · 2023Article
- Strategic use of levofolinic acid for methotrexate-induced side effects in juvenile idiopathic arthritis: a prospective observational study.Pediatric rheumatology online journal · 2023Observational
- Cross-Cultural Adaptation and Validation of the Methotrexate Intolerance Severity Score Questionnaire in Portuguese (Brazil) for Children and Adolescents with Juvenile Idiopathic Arthritis.Journal of clinical medicine · 2023Article
- Machine Learning-Based Prediction Method for Tremors Induced by Tacrolimus in the Treatment of Nephrotic Syndrome.Frontiers in pharmacology · 2022Article
- Real-world data on MTX tolerance with regimens used in children versus adults.Clinical rheumatology · 2021Article
- Morphea: progress to date and the road ahead.Annals of translational medicine · 2021Review
- Genetic Signatures From RNA Sequencing of Pediatric Localized Scleroderma Skin.Frontiers in pediatrics · 2021Article
- Analysis of association of ADORAThe pharmacogenomics journal · 2020Article
- Pharmacological conditioning for juvenile idiopathic arthritis: a potential solution to reduce methotrexate intolerance.Pediatric rheumatology online journal · 2020Article
- Validation of prediction models of severe disease course and non-achievement of remission in juvenile idiopathic arthritis part 2: results of the Nordic model in the Canadian cohort.Arthritis research & therapy · 2020Article
- Validation of prediction models of severe disease course and non-achievement of remission in juvenile idiopathic arthritis: part 1-results of the Canadian model in the Nordic cohort.Arthritis research & therapy · 2019Article
- Methotrexate persistence and adverse drug reactions in patients with juvenile idiopathic arthritis.Rheumatology (Oxford, England) · 2019Article
- Increased methotrexate intolerance in juvenile idiopathic arthritis compared to acute lymphoblastic leukaemia in children.PloS one · 2019Article
Corrections and comments
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Authors and funding
8 authors.
Funding
No grant is acknowledged in the PubMed record.
Abstract
backgroundMethotrexate (MTX) is an effective and safe drug in the treatment of juvenile idiopathic arthritis (JIA). Despite its safety, MTX-related gastrointestinal adverse effects before and after MTX administration, termed MTX intolerance, occur frequently, leading to non-compliance and potentially premature MTX termination. The aim of this study was to construct a risk model to predict MTX intolerance.
methodsIn a prospective JIA cohort, clinical variables and single nucleotide polymorphisms were determined at MTX start. The Methotrexate Intolerance Severity Score was employed to measure MTX intolerance in the first year of treatment. MTX intolerance was most prevalent at 6 or 12 months after MTX start, which was defined as the outcome for the prediction model. The model was developed in 152 patients using multivariable logistic regression analysis and subsequently internally validated using bootstrapping.
resultsThe prediction model included the following predictors: JIA category, antinuclear antibody, parent/patient assessment of pain, Juvenile Arthritis Disease Activity Score-27, thrombocytes, alanine aminotransferase and creatinine. The model classified 77.5% of patients correctly, and 66.7% of patients after internal validation by bootstrapping. The lowest predicted risk of MTX intolerance was 18.9% and the highest predicted risk was 85.9%. The prediction model was transformed into a risk score (range 0-17). At a cut-off of ≥6, sensitivity was 82.0%, specificity 56.1%, positive predictive value was 58.7% and negative predictive value 80.4%.
conclusionsThis clinical prediction model showed moderate predictive power to detect MTX intolerance. To develop into a clinically usable tool, it should be validated in an independent cohort and updated with new predictors. Such an easy-to-use tool could then assist clinicians in identifying patients at risk to develop MTX intolerance, and in turn to monitor them closely and intervene timely in order to prevent the development of MTX intolerance.
trial registrationISRCTN register, www.isrctn.com, ISRCTN13524271.
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Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.