Methotrexate in the combination therapy of juvenile idiopathic arthritis

The paper discusses whether biological agents (BAs) may be used as monotherapy. The combination of different BAs and methotrexate (MTX) allows a good result in patients with juvenile idiopathic arthritis refractory to standard antirheumatic therapy. The efficiency of this therapy meets the ACRpedi50 criteria in 80–90% of patients; one third of patients can achieve the inactive stage of the disease. When BAs are administered, the frequency of use of nonsteroidal anti-inflammatory drugs and glucocorticoids is reduced. In only 15% of patients, MTX can be discontinued during the first year of therapy with BA, significantly more frequently with tocilizumab.