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Original article

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Which accessible clinical features and laboratory findings might predict methotrexate success in children with juvenile idiopathic arthritis in Bosnia and Herzegovina?

By
Adisa Čengić Orcid logo ,
Adisa Čengić
Contact Adisa Čengić

Pediatric Clinic, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Velma Selmanović ,
Velma Selmanović

Pediatric Clinic, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Sniježana Hasanbegović ,
Sniježana Hasanbegović

Pediatric Clinic, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Hamza Izeta ,
Hamza Izeta

Health Centre of Canton Sarajevo, Sarajevo, Bosnia and Herzegovina

Lamija Zečević ,
Lamija Zečević

Clinical Immunology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Nejra Džananović
Nejra Džananović

Clinical Immunology, Clinical Centre of the University of Sarajevo, Sarajevo, Bosnia and Herzegovina

Editor: SELMA UZUNOVIĆ

Abstract

Aim To determine whether demographic data, clinical features, and laboratory variables at disease onset can predict the response to methotrexate in juvenile idiopathic arthritis (JIA) patients. 
Methods A cohort of 143 newly diagnosed JIA patients initially treated with methotrexate was enrolled in this study. Demographic, clinical, and laboratory parameters were analysed using univariate and multivariate logistic regression to identify predictors of response to methotrexate. The variables included erythrocyte sedimentation rate (ESR), C-reactive protein (CRP), platelets, IgA, IgG, the number of active joints and age at disease onset. Treatment response was assessed at six months, with patients classified as responders (those who achieved clinically inactive disease according to the American College of Rheumatology - ACR criteria) or non-responders. 
Results Poor response to methotrexate was associated with the number of active joints (p=0.0001; OR=2.7), baseline levels of CRP (p=0.044; OR=1.138), IgA (p =0.004; OR=2.159), and platelet count (p=0.01; OR=1.05). IgG level (P=0.236) did not correlate with the treatment response. 
Conclusion We identified widely available and clinically acceptable biomarkers that can be utilized as predictive indicators of response to methotrexate in JIA patients.

Author Contributions

Conceptualization, A.Č. and S.H.; Data curation, A.Č., V.S. and H.I.; Formal Analysis, A.Č. and H.I.; Funding acquisition, A.Č.; Investigation, A.Č.; Methodology, A.Č.; Project administration, A.Č.; Resources, A.Č., V.S. and L.Z.; Validation, A.Č., V.S., S.H., H.I., L.Z. and N.D.; Writing – original draft, A.Č.; Writing – review & editing, A.Č., V.S. and H.I.; Supervision, V.S. and S.H.; Software, H.I.; Visualization, H.I. and N.D. All authors have read and agreed to the published version of the manuscript.

Citation

Funding Statement

No specific funding was received for this study

Authors retain copyright. This work is licensed under a Creative Commons Attribution 4.0 International License. Creative Commons License

 

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