AB1000 THE SURVIVAL OF METHOTREXATE IN JUVENILE IDIOPATHIC ARTHRITISCHILDREN AFTER DURING FIRST BIOLOGIC TREATMENT

Abstract

Background Methotrexate (MTX) is a gold standard for treatment of juvenile idiopathic arthritis (JIA) patients. The main adverse events (AE) related to the MTX are intolerance, increased rate of infections, elevation of the liver enzymes, hematological abnormalities and stomatitis, which required to stop the MTX therapy [1]. In children without remission who tolerated MTX often the second-line treatment is the biologics, which may use alone or in the combination with MTX. Objectives The aim of our study was to evaluate the main reasons of MTX discontinuation in JIA children who started first biologic. Methods In the study were included 173 non-systemic JIA patients, whom biologic therapy was prescribed firstly to previous MTX treatment. We evaluate the main reasons of MTX discontinuation after the starting of the biologic treatment, duration of MTX treatment (all and after biologic start), achievement the remission, according C. Wallace criteria and time to remission, flare of JIA. We compared two groups: i) patients with biologics with ongoing methotrexate and ii) patients with biologics alone, whom MTX was discontinued or not prescribed. Results During the trial MTX discontinued 40 (23.1%) patients: due to intolerance (n=11), other adverse events (AE) (n=10), except intolerance (mainly, frequent infection and transaminitis) and remission of JIA (n=19). Patients with onset age of JIA Conclusion The main factor, associated with MTX discontinuation in JIA patients, who received first biologic was the disease onset age. Eldest age was related to higher risk of developing the MTX intolerance.