children s health issues
Juvenile Idiopathic Arthritis (JIA)
Treatment of JIA
Disease-modifying antirheumatic drugs (DMARDs) Sometimes corticosteroids Sometimes nonsteroidal anti-inflammatory drugs (NSAIDs) for symptom relief As in adults, the different forms of juvenile idiopathic arthritis (JIA) are treated with certain arthritis drugs called Disease-modifying antirheumatic drugs (DMARDs) (DMARDs). DMARDs can slow the progression of JIA and have dramatically improved outcomes. Examples of these drugs includemethotrexate;etanercept,adalimumab, andinfliximab(which block tumor necrosis factor-alpha, a protein involved in inflammation);anakinraandcanakinumab(which block interleukin-1, a protein involved in inflammation);tocilizumab(which blocks interleukin-6);tofacitinib(which is a Janus kinase inhibitor); andabatacept.Sulfasalazine, another DMARD, is given occasionally, especially to children who have arthritis of the lower spine. Methotrexateis given to children who have the oligoarticular, psoriatic, or polyarticular form of JIA. Side effects ofmethotrexateinclude a decrease in production of white blood cells, red blood cells, and platelets (bone marrow depression) and liver toxicity, so children taking this drug require regular blood tests. Tocilizumabis given to children who have polyarticular or systemic JIA.Abataceptandtofacitinibare also used for the treatment of systemic JIA and polyarticular JIA.Anakinraandcanakinumabare particularly effective for systemic JIA. given by mouth), but these drugs may be required for children with severe systemic JIA. When corticosteroids are necessary, the lowest possible dose is used to decrease the chance of long-term complications such as slowed growth, Osteoporosis (brittle bones), cataracts, and Iridocyclitis is initially treated with corticosteroid eye drops, which suppress inflammation. If this treatment is not enough,methotrexateis frequently used and, if needed, a drug that blocks the effects of tumor necrosis factor. Eye drops that widen (dilate) the pupil also help prevent permanent eye damage. Eye surgery may be needed if the eye has been damaged. Typically, Nonsteroidal Anti-Inflammatory Drugs (NSAIDs) are given to reduce symptoms and are most useful for enthesitis-related arthritis. However, although NSAIDs help relieve symptoms, they do not stop the progression of joint disease. Nondrug therapies are also used for children. For example, Physical Therapy (PT) , splints, and flexibility exercises help maintain strength and joint function. 