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 .
No efficacy of subcutaneous methotrexate in active ankylosing spondylitis: a 16-week open-label trial
Objective : To examine the potential therapeutic effect of methotrexate 20 mg given weekly as subcutaneous injections to 20 patients with ankylosing spondylitis refractory to non-steriodal antirheumatic drugs . Patients and methods : 20 patients with ankylosing spondylitis , a mean Bath Ankylosing Spondylitis Disease Activity Index ( BASDAI ) score of 5.6 ( range 4–9.3 ) and predominantly axial manifestations were treated with weekly 15 mg methotrexate subcutaneously for 4 weeks , which was then increased to 20 mg subcutaneously for the next 12 weeks . Clinical outcome assessment s included , among others , BASDAI score physical function , spinal mobility , patients ’ and physicians ’ global assessment ( visual analogue scale ) , peripheral joint assessment , quality of life ( Short Form 36 ) and C reactive protein . The primary end point of the study was a 20 % improvement on the ASsessment s in Ankylosing Spondylitis ( ASAS 20 ) scale . Results : Using an intention-to-treat analysis , ASAS 20 was achieved in only 25 % of patients . An ASAS 40 response was achieved in 10 % of patients , and no patient reached an ASAS 70 response or the ASAS criteria for partial remission . For the mean BASDAI score , no change was observed between baseline and week 16 ( baseline 5.6 v week 16 , 5.6 ) . No improvement was observed in any of the clinical parameters or C reactive protein , except a small but non-significant decrease in the number of swollen joints . Conclusions : In this open study , methotrexate did not show any benefit for axial manifestations in patients with active ankylosing spondylitis beyond the expected placebo response
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 .