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Juvenile Idiopathic Arthritis - Medications

Most children with juvenile idiopathic arthritis (JIA) need to take medicine to reduce inflammation and control pain and to help prevent more 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. Your doctor will try to find medicine that helps relieve symptoms and that has few side effects. This may take some time.

Medicine choices

Although treatment varies depending on the needs of each child, certain medicines are often tried first (first-line medicines), while others are often saved to try later if they are needed (second-line medicines). Be safe with medicines. Read and follow all instructions on the label.

Medicines tried first

  • Nonsteroidal anti-inflammatory drugs (NSAIDs). Naproxen is the most often used NSAID treatment for JIA because of its low incidence of side effects compared to its effectiveness.3 Ibuprofen may be used instead. But in general, less than one-third of children will have significant relief from NSAIDs.1 If you see no improvement after 6 weeks, your doctor may try a different NSAID.

Medicines tried later

  • Corticosteroids. Injections can be used for children who have just a few joints affected or who have enthesitis. Steroid medicines by mouth or through an IV are often used for widespread joint pain or systemic problems such as fever or pericarditis. Steroid medicines work faster than some other drugs, so they may also be used until other medicines start working.
  • Disease-modifying antirheumatic drugs (DMARDs). These are also called slow-acting antirheumatic drugs (SAARDs). They include:
  • Antimalarials, such as hydroxychloroquine.
  • Adult therapies, such as other cytotoxic (cell-destroying) drugs and intravenous human immunoglobulin. These may be used for rheumatoid arthritis in adults. But they aren't yet proved to be safe and effective for children with JIA.

Medicines to treat inflammatory eye disease

  • Corticosteroid eyedrops
  • Methotrexate and cyclosporine A
  • Mydriatics, which are eyedrops that dilate the pupil and keep the iris from sticking to the cornea or lens
  • Biologics
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