ONE DISEASE, ONE DRUG: METHOTREXATE IN IJA

Key words: Idiopathic juvenile arthritis, methotrexate

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.