ArticleRheumatology (Oxford, England)2019
Methotrexate persistence and adverse drug reactions in patients with juvenile idiopathic arthritis.
Article in Rheumatology (Oxford, England), 2019. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 13 papers.
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Who cites it
13 citing papers in PubMed.
- Changes in systemic medication in children and adolescents with JIA: why, when and which patterns.Rheumatology (Oxford, England) · 2026Article
- Considerations for Biosimilar Adoption in Pediatrics: A Scoping Review.Pharmaceutical medicine · 2026Article
- The evolving landscape of rheumatic drugs and their indications in paediatric and adolescent care.Rheumatology (Oxford, England) · 2025Review
- Observational
- Efficacy and safety of tofacitinib treatment in Finnish patients with juvenile idiopathic arthritis: a real-life study.Arthritis research & therapy · 2025Article
- Trends in New Use of Disease-Modifying Antirheumatic Drugs for Juvenile Idiopathic Arthritis Among Commercially Insured Children in the United States from 2001 to 2022.Arthritis & rheumatology (Hoboken, N.J.) · 2025Article
- Methotrexate Intolerance in Juvenile Idiopathic Arthritis: Definition, Risks, and Management.Paediatric drugs · 2024Review
- Pharmacological treatment patterns in patients with juvenile idiopathic arthritis in the Netherlands: a real-world data analysis.Rheumatology (Oxford, England) · 2023Article
- Is time a healer? How quality of life changes over time reported by parents of children and young people with juvenile idiopathic arthritis.Rheumatology (Oxford, England) · 2023Article
- Real-world comparison of the effects of etanercept and adalimumab on well-being in non-systemic juvenile idiopathic arthritis: a propensity score matched cohort study.Pediatric rheumatology online journal · 2022Article
- Biologic Disease-Modifying and Other Anti-Rheumatic Drugs Use in Patients with Moderate-to-Severe Juvenile Idiopathic Arthritis Based on a Japanese Nationwide Claims Database.Therapeutics and clinical risk management · 2022Article
- Persistence and adherence to biologic therapies in juvenile idiopathic arthritis.Scientific reports · 2021Observational
- Reduction in the utilization of prednisone or methotrexate in Canadian claims data following initiation of etanercept in pediatric patients with juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2019Article
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Authors and funding
12 authors.
Funding
Abstract
objectivesThis analysis aims to calculate MTX monotherapy persistence and describe the occurrence of and factors associated with the occurrence of adverse drug reactions (ADRs) with MTX.
methodsPatients with JIA starting MTX monotherapy from two UK studies were included. Patient characteristics, treatment details and ADR occurrence were collected at treatment start, 6 months, 1 year and annually. The following groups of ADRs were included: gastrointestinal, elevated liver enzymes, leukopenia, drug hypersensitivity, rash, needle phobia and any events leading to permanent MTX discontinuation. Treatment exposure was calculated from MTX start until MTX monotherapy cessation, last follow-up or 31 December 2017 (cut-off), whichever came first. Survival analysis assessed the time on MTX monotherapy and the time to the first ADR on MTX monotherapy within 2 years. Multivariable logistic regression assessed characteristics associated with any ADR and gastrointestinal ADRs.
resultsA total of 577 patients started MTX. At 2 years, 310 (54%) were no longer on MTX monotherapy. Reasons included ineffectiveness (60%; 161/185 started a biologic), adverse event (25%), remission (8%) and patient/family decision (3%). Over this time, 212 (37%) patients experienced one or more ADR; commonly gastrointestinal (68%) or elevated liver enzymes (26%). Lower physician global assessment and older age predicted any ADR and gastrointestinal ADR, respectively. Patients with polyarticular RF and JIA had reduced odds of both any ADR and a gastrointestinal ADR.
conclusionAfter 2 years, more than half the patients were no longer on MTX monotherapy, while more than one-third experienced one or more ADR, most commonly gastrointestinal. Research focusing on identifying which children will respond and/or experience ADRs is crucial to inform treatment decisions and management planning.
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