Farmacologia clinica
Un farmaco, una malattia: il methotrexate nell’artrite giovanile
ONE DISEASE, ONE DRUG: METHOTREXATE IN IJA
LOREDANA LEPORE
Clinica Pediatrica, IRCCS “Burlo Garofolo”, Trieste
Giugno 2000 - pagg. 361 -363
Abstract
In 1992 a pioneer collaborative study showed that methotrexate (M) is effective in paediatric
reumatology. Now we know that 60% of IJA patients who do not respond to non-steroidal
antinflammatory drugs respond to M, that the best response is observed in pauciarticular
forms evolving in poliarticular as well as in poliarticular forms at onset. Side effects are
mainly gastroenteric, but they rarely cause withdrawal of treatment. No gonadal damage
and no increased risk of cancer have been observed. The administration of folinic acid reduces
the likelihood of side effects. Oral M is as effective as intramuscular M. M should be
considered the first choice long-acting drug for all forms of IJA.
Parole chiave
Suggerite dall'AI
Classificazione MeSH
Bibliografia
1. Giannini EH, Brewer EJ, Kusmina N, et al.
Methotrexate in resistant Juvenile Rheumatoid
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bind, placebo-controlled trial. The Pediatric
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2. Ravelli A, Viola S, Migliavaca D, et al. The extended oligoarticular subtype is the best predictor of methotrexate efficacy in juvenile idiopathic arthritis. J Pediatrics 1999;3:135.
3. Shiroky JB, Neville C, Esdaile JM, et al. Low-dose methotrexate with leucovorin (folinic acid) in the management of rheumatoid arthritis. Results of a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum 1993;36:795.
4. Ravelli A, Gerloni V, Corona F, at al. Oral versus intramuscolar methotrexate in juvenile chronic arthritis. Clin Exp Rheumatol 1998; 16:181.
5. Kugathasan S, Newman AJ, Dahms BB et al. Liver biopsy findings in patients with juvenile rheumatoid arthritis receiving longterm, weekly methotrexate therapy. J Pediatrics 1996;128:149.
6. Hashkes PJ, Balistreri WF, Bove KE, et al. The relationship of hepathotoxic risk factors and liver hystology in methotrexate therapy for juvenile rheumatoid arthritis. J Pediatrics 1999;1:134.
7. Ravelli A, Viola S, Ramenghi B, et al. Radiologic progression in patients with juvenile chronic arthritis treated with methotrexate. J Pediatrics 1998;133:262.
8. Imokawa S, Colby TV, Leslie KO, et al. Methotrexate pneumonitis: review of the literature and histopatological findings in nine patients. Eur Respir J 2000;15(2):373.
2. Ravelli A, Viola S, Migliavaca D, et al. The extended oligoarticular subtype is the best predictor of methotrexate efficacy in juvenile idiopathic arthritis. J Pediatrics 1999;3:135.
3. Shiroky JB, Neville C, Esdaile JM, et al. Low-dose methotrexate with leucovorin (folinic acid) in the management of rheumatoid arthritis. Results of a multicenter randomized, double-blind, placebo-controlled trial. Arthritis Rheum 1993;36:795.
4. Ravelli A, Gerloni V, Corona F, at al. Oral versus intramuscolar methotrexate in juvenile chronic arthritis. Clin Exp Rheumatol 1998; 16:181.
5. Kugathasan S, Newman AJ, Dahms BB et al. Liver biopsy findings in patients with juvenile rheumatoid arthritis receiving longterm, weekly methotrexate therapy. J Pediatrics 1996;128:149.
6. Hashkes PJ, Balistreri WF, Bove KE, et al. The relationship of hepathotoxic risk factors and liver hystology in methotrexate therapy for juvenile rheumatoid arthritis. J Pediatrics 1999;1:134.
7. Ravelli A, Viola S, Ramenghi B, et al. Radiologic progression in patients with juvenile chronic arthritis treated with methotrexate. J Pediatrics 1998;133:262.
8. Imokawa S, Colby TV, Leslie KO, et al. Methotrexate pneumonitis: review of the literature and histopatological findings in nine patients. Eur Respir J 2000;15(2):373.