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
DMARDs/SAARDs include azathioprine,
cyclosporine, etanercept, methotrexate, and sulfasalazine.
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
- They have a moderate risk of side effects that may be
uncomfortable but are not serious (nausea, skin rash, mouth sores, diarrhea,
- 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withdrawn from DMARD/SAARD treatment.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.