A controlled trial of intra-articular corticosteroids with or without methotrexate in oligoarticular juvenile idiopathic arthritis

There is paucity of evidence-based information to guide treatment of oligoarticular juvenile idiopathic arthritis (JIA). We aimed to investigate whether combination with methotrexate increases the efficacy of intra-articular corticosteroid (IAC) therapy in patients with JIA. The report describes our preliminary experience in children aged 18 years or younger who were candidates to receive IAC in one to four joints. We randomly allocated a subgroup of patients via a computer-based system to IAC alone or in combination with methotrexate. Our primary outcome in intention to treat analysis was the proportion of patients achieving remission of synovitis in all injected joints at 12 months.