EVALUATION OF RESPONSE TO METHOTREXATE BY A FUNCTIONAL INDEX IN JUVENILE CHRONIC ARTHRITIS

In juvenile chronic arthritis (JCA) the indices of disease activity, s uch as joint swelling, pain, tenderness, and limitation of motion, may poorly correlate with the degree of functional impairment, Since the improvement of functional capacity is one of the main objectives of tr eatment, we evaluated the effect of methotrexate (MTX) in 29 children with JCA by assessing both the articular indices and a functional stat us measure, After 6 months of therapy, 15 of the 29 patients had a sig nificant (greater than or equal to 50%) reduction in the number of joi nts with active arthritis and/or the articular severity score and were then judged as responders, while 14 did not respond to MTX, In the re sponder group, the median functional index score decreased from 17 (ra nge: 13-27) at baseline to 13 (range: 13-15) at 6 months (p < 0.001); the median score of the non-responder group was 20 both at baseline an d at 6 months (ranges: 14-27, and 13-36, respectively). These results show an improvement of functional impairment in those patients who res pond to MTX according to the conventional indices of articular inflamm ation.