Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .
Efficacy of methotrexate in ankylosing spondylitis: a randomized, double blind, placebo controlled trial.
OBJECTIVE To evaluate the efficacy and safety of methotrexate ( MTX ) compared with placebo in patients with active ankylosing spondylitis ( AS ) . METHODS This 24 week , double bind , r and omized , placebo controlled trial compared the response between MTX 7.5 mg/week or placebo in patients with active AS . The primary outcome measure was a composite index of improvement in 5 of the following scales : severity of morning stiffness , physical well being , the Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) , the Bath Ankylosing Spondylitis Functional Index ( BASFI ) , the Health Assessment Question naire for Spondyloarthropathies ( HAQ-S ) , and physician and patient global assessment of disease activity . RESULTS Seventeen patients received MTX and 18 placebo .  In the intention-to-treat analysis at 24 weeks , 53 % of patients in the MTX group had a treatment response , compared with 17 % in the placebo group ( p = 0.03 ) . We observed significant improvements with MTX in physical well being ( p = 0.009 ) , BASDAI ( p = 0.02 ) , BASFI ( p = 0.02 ) , physician global assessment ( p < 0.001 ) , patient global assessment ( p = 0.03 ) , and HAQ-S ( p = 0.02 ) . In the adjusted analysis only MTX determined the improvement in the primary outcome . At the end of the trial , one patient with MTX  withdrew due to a lack of compliance , and one with placebo due to a lack of efficacy . We did not observe significant differences in rates of side effects between the 2 groups . CONCLUSION MTX is safe and effective for patients with AS . Longterm studies are needed to evaluate the permanence of its benefit
Good disease control , with therapeutic escalation to achieve low disease activity , was recommended .
OBJECTIVE To develop treatment recommendations for children with juvenile idiopathic arthritis manifesting as non-systemic polyarthritis , sacroiliitis , or enthesitis .