Juvenile Rheumatoid Arthritis (JRA)
How Is Juvenile Rheumatoid Arthritis Treated?
Treatment for JRA is essentially the same as for adults with RA. Treatment usually includes medications along with exercise.
The goals of treatment for JRA include:
- Controlling the inflammatory process
- Easing pain and swelling.
- Increasing joint motion and strength.
- Preventing joint damage and other complications that can occur.
Which Medications Are Used to Treat Juvenile Rheumatoid Arthritis?
Medications for juvenile rheumatoid arthritis may include:
Nonsteroidal anti-inflammatory drugs (NSAIDs)
NSAIDs are used to reduce pain, fever, and inflammation.
NSAIDs are given through a liquid or pill. These drugs are typically taken from one to four times a day. Some common NSAIDs on the market are naproxen (Naprosyn), ibuprofen (Motrin or Advil), tolmentin, and aspirin.
While NSAIDs may help ease pain and inflammation, they also have side effects. Some common side effects include stomach pain, nausea, vomiting, headache, and anemia. Sometimes the doctor will give another stomach-protecting medication to take with the NSAIDs to reduce the risk of stomach bleeding.
Disease-modifying anti-rheumatic drugs (DMARDs)
DMARDs may be added to the medication regimen to slow or stop the progression of the joint disease. These drugs also help with joint stiffness, pain, and swelling.
The true effects of DMARDs are not felt immediately and may take about three to six months to work. This is why DMARDs are referred to as "slow-acting." Examples of DMARDs include Plaquenil, Azulfidine, and Methotrexate.
Because DMARDs are strong drugs, the child will need frequent tests to monitor the drug and its side effects such as anemia, low blood count, and kidney and liver problems. Other side effects may include stomachaches, diarrhea, vomiting, nausea, headaches, rashes, loss of appetite, and weakness.
Biological modifying agents
Biological agents, or biologics, are also DMARDs. Biologics are made of synthetic proteins and antibodies that block TNF and other substances that cause inflammation.
Examples of biologics include Enbrel, Humira, Kineret, and Remicade.
Potentially serious side effects of the biologics include allergic reactions and an increased risk of infection including tuberculosis. Because some biologics have only been FDA-approved for use in adults, clinical trials are under way to check their effectiveness in children. Check with your doctor about which ones are appropriate for children.
These powerful anti-inflammatory drugs are usually only prescribed when the patient does not respond to other treatment or if the disease is severe.
Steroids come in pills or liquids. When a patient is only affected in a single joint, a steroid injection may be given directly into that joint.
Oral steroids are usually prescribed for short periods of time and in low dosages. There are some serious side effects associated with long-term usage. Side effects include stunted growth, ulcers, mood swings, weight gain, moon face, muscle weakness, high blood pressure, osteoporosis, cataracts, and infections.
Examples of steroids include dexamethasone, methylprednisolone, hydrocortisone, prednisolone, and prednisone.