EXPERIENCE OF THE EFFICIENT USING OF METHOTREXATE FOR SUBCUTANEOUS ADMINISTRATION IN PATIENT WITH POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS
https://doi.org/10.15690/vsp.v13i4.1101
Abstract
The article describes successful case of the methotrexate monotherapy through subcutaneous administration (15 mg/m2 of body surface per week) for treatment of the polyarticular juvenile idiopathic arthritis in the girl in the age of 4. After 6 and 12 months of the methotrexate therapy the significant reduction of the clinical and laboratory disease activity indices and increase in functional activity of the child according to the pediatric ACR criteria for 50 and 90% respectively were observed. No adverse experience during the monotherapy was recorded. Development of inactive disease phase after 15 months of treatment allows predicting the development of pharmacological remission in patient in the prospective. Timely (immediately after the disease was diagnosed) administration of methotrexate allowed preventing the disablement of the child and improving the life quality of both the patient and her family.
About the Authors
S. A. Ushakova
Tyumen State Medical Academy
Russian Federation
Ushakova Svetlana Anatol’evna, MD, associate professor of Pediatric Department of Advanced Training and Retraing of Medical Specialists Faculty
Russian Federation
Ushakova Svetlana Anatol’evna, MD, associate professor of Pediatric Department of Advanced Training and Retraing of Medical Specialists Faculty
O. V. Pavlova
Tyumen State Medical Academy;
Regional Clinical Hospital № 1, Tyumen
Russian Federation
Russian Federation
O. Yu. Khalidullina
Tyumen State Medical Academy;
Regional Clinical Hospital № 1, Tyumen
Russian Federation
Russian Federation
V. N. Lukyanova
Regional Clinical Hospital № 1, Tyumen
Russian Federation
Russian Federation
References
1. Alexeeva E. I., Litvitskii P. F. Yuvenil’nyi revmatoidnyi artrit: etiologiya, patogenez, klinika, algoritmy diagnostiki i lecheniya: Ruk-vo dlya vrachei, prepodavatelei, nauch. sotr. Pod obshch. red. A. A. Baranova [Juvenile Rheumatoid Arthritis: Etiology, Pathogenesis, Clinical Algorithms for Diagnosis and Treatment: Guideline for Doctors, Tutors, Research Scientists. Edited by A. A. Baranov]. Moscow, VEDI, 2007. 368 p.
2. Ruk-vo po detskoi revmatologii. Pod red. N. A. Geppe, N. S. Podchernyaevoi, G. A. Lyskinoi [Guideline in Pediatric Rheumatology. Edited by N. A. Geppe, N. S. Podchernyaeva, G. A. Lyskina]. Moscow, GEOTAR-Media, 2011. 720 p.
3. Rodionovskaya S. R., Nikishina I. P. Nauch.-prakt. revmatol. — Science-practical rheumatology. 2003; 2: 65–71.
4. Alekseeva E. I., Valieva S. I., Bzarova T. M., Denisova R. V. Vopr. sovr. pediatrii — Current pediatrics. 2011; 10 (1): 42–49.
5. Giannini E. H., Brewer E. J., Kuzmina N., Shaikov A., Maximov A., Vorontsov I., Fink C. W., Newman A. J., Cassidy J. T., Zemel L. S. Methotrexate in resistant juvenile rheumatoid arthritis. Results of the U.S.A. — U.S.S.R. double-blind, placebo-controlled trial. The Pediatric Rheumatology Collaborative Study Group and The Cooperative Children's Study Group. N. Engl. J. Med. 1992; 12 (16): 1043–1049.
6. Baranov A. A., Alexeeva E. I., Bzarova T. M., Valieva S. I., Deni sova R. V., Isaeva K. B., Karagulyan N. A., Litvitskii P. F., Mitenko E. V., Sleptsova T. V., Fetisova A. N., Chistyakova E. G., Taibulatov N. I., Morev S.Yu. Vopr. sovr. pediatrii — Current pediatrics. 2013; 12 (1): 37–56.
7. Beukelman T., Patkar N. M., Saag K. G., Tolleson-Rinehart S., Cron R. Q., DeWitt E. M., Ilowite N. T., Kimura Y., Laxer R. M., Lovell D. J. American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res. (Hoboken). 2011; 12 (4): 465–482.
8. Dueckers G., Guellac N., Arbogast M. Evidence and consensus based GKJR guidelines for the treatment of juvenile idiopathic arthritis. Clin. Immunol. 2012; 142: 176–193.
9. Nikishina I. P., Kuz'mina N. N. Vestnik RAMN — Annals of the Russian Academy of Medical Sciences. 2008; 6: 41–48.
10. Beukelman T., Ringold S., Davis T. E., DeWitt E. M., Pelajo C. F., Weiss P. F., Kimura Y. Disease-modifying antirheumatic drug use in the treatment of juvenile idiopathic arthritis: a cross-sectional analysis of the CARRA Registry. J. Rheumatol. 2012; 12 (9): 1867–1874.
11. Yaremenko O. B. Ukrains’kii Revmatologichnyi zhurn. — Ukrainsky Revmatologichny journal. 2002; 3 (9): 45–51.
12. Alekseeva E. I., Sleptsova T. V., Valieva S. I., Bzarova T. M., Denisova R. V., Isaeva K. B., Mitenko E. V., Chistyakova E. G., Fetisova A. N., Taibulatov N. I. Vopr. sovr. pediatrii — Current pediatrics. 2013; 12 (4): 38–46.
13. Ruperto N., Murray K. J., Gerloni V., Wulffraat N., de Oliveira S. K., Falcini F., Dolezalova P., Alessio M., Burgos-Vargas R., Corona F., Vesely R., Foster H., Davidson J., Zulian F., Asplin L., Baildam E., Consuegra J. G., Ozdogan H., Saurenmann R., Joos R., Pistorio A., Woo P., Martini A. A randomized trial of parenteral methotrexate comparing an intermediate dose with a higher dose in children with juvenile idiopathic arthritis who failed to respond to standard doses of methotrexate. Arthritis Rheum. 2004; 12 (7): 2191–2201.
14. Tukova J., Chladek J., Nemcova D., Chladkova J., Dolezalova P. Methotrexate bioavailability after oral and subcutaneous administration in children with juvenile idiopathic arthritis. Clin. Exp. Rheumatol. 2009; 12 (6): 1047–1053.
15. Klein A., Kaul I., Foeldvari I., Ganser G. et al. Efficacy and safety of oral and parenteral methotrexate therapy in children with juvenile idiopathic arthritis: an observational study with patients from the German Methotrexate Registry. Arthr. Care Res. (Hoboken). 2012; 64 (9): 1349–1356.
Review
For citations:
Ushakova S.A., Pavlova O.V., Khalidullina O.Yu., Lukyanova V.N. EXPERIENCE OF THE EFFICIENT USING OF METHOTREXATE FOR SUBCUTANEOUS ADMINISTRATION IN PATIENT WITH POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS. Current Pediatrics. 2014;13(4):150-155. (In Russ.) https://doi.org/10.15690/vsp.v13i4.1101
Views:
794
Email this article 
