[Methotrexate in the therapy of juvenile idiopathic arthritis]

Z Rheumatol. 2010 Aug;69(6):496-504. doi: 10.1007/s00393-010-0633-1.
[Article in German]


Treatment with low-dose methotrexate (MTX) is an important element in the therapy of juvenile idiopathic arthritis (JIA). It could be demonstrated in placebo-controlled trials that MTX is a safe and effective drug which is generally well tolerated by children and adolescents. MTX is usually used at a dose of 10-15 mg/m(2)/week, whereby oral administration is preferred for children. Side effects occur mainly in the form of gastro-intestinal discomfort such as nausea and vomiting or raised transaminases, which can be effectively treated with folic-acid supplementation.There are no general recommendations to date regarding in particular duration and discontinuation of MTX treatment or combination treatment with other disease-modifying antirheumatic drugs or biologics. These unresolved questions are the subject of current trials in which biomarkers have an increasingly important role.

Publication types

  • English Abstract
  • Review

MeSH terms

  • Adolescent
  • Antirheumatic Agents / adverse effects
  • Antirheumatic Agents / pharmacokinetics
  • Antirheumatic Agents / therapeutic use*
  • Arthritis, Juvenile / blood
  • Arthritis, Juvenile / diagnosis
  • Arthritis, Juvenile / drug therapy*
  • Child
  • Controlled Clinical Trials as Topic
  • Dose-Response Relationship, Drug
  • Drug Therapy, Combination
  • Folic Acid / therapeutic use
  • Humans
  • Methotrexate / adverse effects
  • Methotrexate / pharmacokinetics
  • Methotrexate / therapeutic use*
  • Treatment Outcome


  • Antirheumatic Agents
  • Folic Acid
  • Methotrexate