Most children with
juvenile idiopathic arthritis (JIA) need to take
medicine to reduce inflammation and control pain and to help prevent increasing
damage to the joints. When inflammation and pain are controlled, a child is
more willing and able to do joint exercises to improve joint strength and
prevent loss of movement.
Many different medicines are used to
treat JIA. No single medicine works for every child. It may take some time to
find the right medicine or combination of medicines that best controls your
child's symptoms. Treatment is tailored to each child by his or her
doctor and parents while considering effectiveness, side effects, cost, and the
type and severity of the disease.
Did you know there is more than one type of arthritis? In fact, there are more than 100 types of arthritis. It's a condition that affects more than 46 million U.S. adults -- a number that's expected to increase to 67 million adults by the year 2030.
The false notion that all arthritis is alike has led people to try treatments that have little effect on their arthritis symptoms. Since each type of arthritis is different, each type calls for a different approach to treatment. That means an accurate...
Although treatment varies depending on the needs of the
individual child, certain medications are often tried first (first-line
medications), while others are often saved to try later if they are needed
First-line medication. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first medicines tried to
control JIA inflammation and symptoms. Naproxen is the most frequently
used NSAID treatment for JIA. Doctors choose naproxen based on its low
incidence of side effects compared to its effectiveness.6Ibuprofen is an effective alternative. But in general, less
than one-third of children will have significant relief from NSAIDs.3
Corticosteroids may also be used as a first-line
medication, especially as injections, for children who have
just a few joints affected or who have enthesitis. Oral or
intravenous (IV) corticosteroids are often used for
widespread joint pain or systemic problems such as fever or pericarditis. Corticosteroids work faster than some other drugs, so they may also be used until other medicines start working.
Second-line medication. If symptoms are not
well-controlled with NSAIDs or corticosteroids, stronger medicines such as
methotrexate are often used successfully.7
Methotrexate, sulfasalazine, and other second-line medicines are sometimes
referred to as
disease-modifying antirheumatic drugs (DMARDs). Some
experts prefer to call them slow-acting antirheumatic drugs (SAARDs).
Some children with JIA gain significant benefit from early methotrexate
treatment. Although there is no definitive way of knowing which children are
the best candidates for early methotrexate treatment, this practice is becoming
more common in an effort to prevent joint and eye damage. Early treatment with
methotrexate is often used for polyarticular JIA.3
Biologic therapy is a newer option to treat
JIA that does not respond to other treatments.
Biologics such as etanercept have had some success in relieving symptoms and decreasing the number of flare-ups.
Adult therapies, such as cytotoxic (cell-destroying)
drugs and intravenous human immunoglobulin, that may be used for rheumatoid
arthritis in adults but are not yet proved to be safe and effective for
children with JIA