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  • Title: Frequency of relapse after discontinuation of methotrexate therapy for clinical remission in juvenile rheumatoid arthritis.
    Author: Ravelli A, Viola S, Ramenghi B, Aramini L, Ruperto N, Martini A.
    Journal: J Rheumatol; 1995 Aug; 22(8):1574-6. PubMed ID: 7473486.
    Abstract:
    OBJECTIVE: To investigate the outcome of children with juvenile rheumatoid arthritis (JRA) who discontinued taking methotrexate (MTX) therapy after the achievement of clinical remission. METHODS: We conducted a retrospective review of the clinical course of all consecutive patients with JRA treated with MTX at our department. RESULTS: Seventeen of the 30 patients who responded to treatment entered clinical remission 6 to 30 mo after beginning MTX therapy. All patients were discontinued from MTX within 2 to 5 mo. Five patients relapsed within 9 mo, whereas 12 patients had sustained remission for 12 mo or longer. Four of 5 children with extended pauciarticular JRA relapsed early after MTX discontinuation. These patients were less responsive to a further cycle of MTX, and 3 showed progression of radiographic joint lesions. CONCLUSION: These findings suggest that MTX should be continued in patients with extended pauciarticular JRA even after the achievement of clinical remission.
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