Aksit S.Egemen A.Caglayan S.Parlar A.Kansoy S.2019-10-272019-10-2719980010-01610010-0161https://hdl.handle.net/11454/23629Twelve children with resistant juvenile rheumatoid arthritis were given 10 mg of oral methotrexate per square meter of body-surface area per week for eight to 24 months (mean±SD, 18±6 months). The patients were eight to 16 years old (mean 10.9±2.4 years) and the mean duration of the disease was 4.5±1.6 years (range, two to nine years). The patients had active polyarthritis at the onset of the methotrexate therapy. All the patients had used hydroxychloroquine, and four of them also sulfasalazine as second-line agents. Methotrexate therapy decreased swelling count by a mean of 47 percent, swelling index by 55 percent, articular count 52%, articular index by 54 percent and morning stiffness by 65 percent. In addition, methotrexate therapy increased hemoglobin value by more than 2 gm/dl in four (33%) patients and decreased the number of platelets by more than 200,000/mm3 in three (25%) patients. The erythrocyte sedimentation rate was 80±26 mm/hr and 32±18 mm/hr before and after methotrexate therapy, respectively. No adverse effects severe enough to withdraw methotrexate therapy were observed during the study. Compliance with methotrexate therapy was complete in all patients. From the data presented here, we conclude that low-dose oral methotrexate is an effective treatment for children with resistant juvenile rheumatoid arthritis. We recommend earlier consideration of methotrexate in place of other slow-acting antirheumatic drugs of cases of juvenile rheumatoid arthritis not responding well to usual therapy.trinfo:eu-repo/semantics/closedAccessJuvenile rheumatoid arthritisMethotrexate slow-acting antirheumatic drugsArticle4115563Q4