Reasons for stopping methotrexate treatment in patients with juvenile idiopathic arthritis

Abstract

We included 98 patients (median age 15.4 ± 7.5 years) who had a definitive diagnosis of JIA and used MTX. Seventy-six (78%) patients were females. The JIA subtype most frequently observed was polyarticular. Routes of administration of MTX observed were subcutaneous (55%) and oral (13%), but many patients throughout the treatment used both adminis tration (32%) in order to improve adherence to treatment. After a mean follow-up time of 5 years, 51 (52%) of these patients discontinued treatment and 47 (48%) of them were still on treatment, but only 35 (74%) were adherent. Sixty-eight (69%) JIA patients reported the presence of sporadic episodes of adverse reactions during treatment. Episodes of adverse reactions related to MTX was mainly gastric intolerance (abdominal discomfort, nausea and vomiting). There were three cases of elevated transaminase levels and one case of neutropenia. The reasons for JIA patients discontinue treatment with MTX was presence of side effects (35%), interruption on their own decision (27%), treatment abandonment (12%) and other reasons such as pregnancy, chickenpox and lack of medication in the public hospitals (12%), improvement of the disease (8%), and inefficacy (6%). All patients who discontinued MTX on their own decision had additionally the presence of side effects. Conclusion