Dr. Ramanan and collaborators responded that, in pediatric care, oral methotrexate may occasionally be used when the child lacks the ability to cope with weekly subcutaneous injections. “In our trial, we did not specify that children had to be receiving methotrexate subcutaneously in order to avoid restricting our ability to enroll participants and in view of issues of acceptability regarding the subcutaneous route in some children,” they write in correspondence to the editor. “We did not undertake pharmacokinetic studies of either methotrexate or adalimumab in this trial.”
Lara C. Pullen, PhD, is a medical writer based in the Chicago area.
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References
- Ramanan AV, Dick AD, Jones AP, et al. Adalimumab plus methotrexate for uveitis in juvenile idiopathic arthritis. N Engl J Med. 2017 Apr 27;376(17):1637–1646. doi: 10.1056/NEJMoa1614160.
- Thorne JE. Adalimumab in the treatment of uveitis in juvenile idiopathic arthritis. N Engl J Med. 2017 Apr 27;376(17):1682–1683. doi: 10.1056/NEJMe1701811.
- Peng S, Sun X, Sun M. Letter to the editor: Adalimumab for uveitis in juvenile idiopathic arthritis. N Engl J Med. 2017 Aug 24.