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Subclinical markers predict relapse in juvenile idiopathic arthritis post methotrexate withdrawal
Date:6/11/2009

Copenhagen, Denmark, Thursday 11 June 2009: Elevated levels of the inflammatory biomarkers Myeloid Related Protein (MRP*) 8/14 predict an increased risk of relapse following withdrawal of methotrexate (MTX) therapy in children with juvenile idiopathic arthritis (JIA) who have achieved inactive disease status, according to a new study presented today presented today at PReS 2009, a joint congress with the 2009 Congress of the European League Against Rheumatism (EULAR) in Copenhagen, Denmark.

Effective treatment options are available to treat rhematic diseases, many of which have the potential to induce remission, defined as absence of signs or symptoms of disease. While there is evidence-based advice regarding when to initiate therapy in rheumatic diseases, there is no specific guidance on the timing of treatment withdrawal once a state of remission on medication is achieved. While this holds true for many autoimmune disease (such as Rheumatoid Arthritis, Crohn's disease, Ulcerative Colitis, or Autoimmune Hepatitis), in the case of MTX therapy for JIA, a continuation of MTX for 12 to 24 months after induction of remission has been proposed by researchers.1

The risk of relapse in JIA patients, once MTX is discontinued, is approximately 50%.2 However, the results of this study have shown that continuing MTX therapy past the point of remission does not affect the risk of relapses after withdrawal of therapy. Clinical (disease subtype, duration or dosage of therapy, duration of MTX therapy) or standard laboratory tests (c-reactive protein and erythrocyte sedimentation rate as measurements of inflammation) could not differentiate between patients at-risk for relapse and those without this risk. However, MRP8/14 levels were significantly higher at MTX withdrawal in remission in those patients who subsequently developed relapses (715140 ng/ml) compared to patients with stable remission (400105 ng/ml; p=0.003).

Levels of MRP8/14 were especially high in p
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Contact: Rory Berrie
eularpressoffice@uk.cohnwolfe.com
44-078-943-86425
European League Against Rheumatism
Source:Eurekalert

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