Ретроспективный анализ эффективности и безопасности метотрексата для подкожного введения у больных ювенильным идиопатическим артритом

Aim : to assess efficacy and safety of hypodermic methotrexate injections in children aged from 1,5 to 16 years old with juvenile idiopathic arthritis (JIA) without extra-articular manifestations. Patients and methods : the results of treatment of 104 patients with JIA without systemic manifestations (61 girls and 43 boys) aged 5,0 (1,5–16) years old being followed-up in the rheumatology department of FSFI «SCCH» of RAMS were analyzed. The mean duration of the disease at the moment of methotrexate first administration was 6 months. Efficacy of methotrexate therapy was assessed according to the pediatric criteria for improvement of the American College of Rheumatology. The percentage of non-active stage and medicinal remission achievement were considered to be the target characteristics of therapy efficacy. Results : 61 patients (59%) were maintained in the study during 1 year. In 12 months of treatment remission according to C. Wallace criteria was induced in 39 of 104 (38%) children. In 22 (21%) of patients who failed to achieve remission in 1 year of treatment, 70% improvement was observed. Side effects were found in 45 (43%) of children: mild and moderate — in 33 (32%), severe — in 12 (12%) of patients. In 9 patients methotrexate was withdrawn due to intolerance of the drug. These patients as well as 34 children with resistance to performed treatment were administered genetically engineered biological agents. Conclusions : hypodermic injections of methotrexate are highly efficient in patients with JIA without extra-articular manifestations. Early administration at the dose of 15 mg/m 2 of body surface as well as appropriate selection of administration form induced remission and allowed to prevent of disability development in 38% of children.