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Juvenile Idiopathic Arthritis: Features of DMARD and SSARD Drugs - Topic Overview

Children who have juvenile idiopathic arthritis (JIA) are first treated with nonsteroidal anti-inflammatory drugs (NSAIDs) that often provide relief and reduce inflammation. NSAIDs are considered the first-line treatment for JIA. Second-line drug therapy—known interchangeably as disease-modifying antirheumatic drugs (DMARDs) and as slow-acting antirheumatic drugs (SAARDs)—for JIA may be recommended when a child continues to have joint pain, swelling, or both despite rest, exercise, use of NSAIDs, and physical therapy.

DMARDs/SAARDs include azathioprine, cyclosporine, etanercept, methotrexate, and sulfasalazine.

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DMARDs/SAARDs have a lot in common.

  • They are slow to take effect. It may take 8 to 24 weeks for the drug to show a benefit.
  • They have a small risk of serious side effects (on blood cells, eyes, kidney, or liver). Side effects can be detected with close monitoring and are reversible if the drug is stopped.
  • They have a moderate risk of side effects that may be uncomfortable but are not serious (nausea, skin rash, mouth sores, diarrhea, hair thinning).
  • While these medicines offer effective treatment for many children, they are not a reasonable treatment option for others. Side effects or ineffectiveness, or both, are common reasons that children are withdrawn from DMARD/SAARD treatment.
  • NSAIDs are often used together with one of these medicines.

Although these medicines are often called "disease-modifying," it has been hard to prove that they truly prevent long-term joint damage. But they often relieve pain and swelling.

    This information is produced and provided by the National Cancer Institute (NCI). The information in this topic may have changed since it was written. For the most current information, contact the National Cancer Institute via the Internet web site at http:// cancer .gov or call 1-800-4-CANCER.

    WebMD Medical Reference from Healthwise

    Last Updated: June 05, 2012
    This information is not intended to replace the advice of a doctor. Healthwise disclaims any liability for the decisions you make based on this information.
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