Arthritis in Children - 2001 National Meeting (cont.)

There are three main forms of JRA, which are distinguished by how the disease begins; pauciarticular, polyarticular, and systemic onset (also called Still's Disease). Pauciarticular JRA is defined by the involvement of fewer than four joints at the beginning of the disease. Polyarticular JRA is the form in which four or more joints are involved from the onset. Systemic Onset (Still's Disease) begins with high fevers and a rash.

JRA can be associated with a severe inflammation of the eye, called uveitis. Uveitis is the most common cause of blindness in these children.

With proper treatment, most children with arthritis usually get better over time.

New Treatments


Remicade (infliximab) is an antibody that blocks the effects of tumor necrosis factor alpha (TNF-alpha). TNF-alpha is a substance made by cells of the body that has an important role in promoting inflammation. By blocking the action of TNF-alpha, infliximab reduces the signs and symptoms of inflammation. Remicade, an approved treatment for adult rheumatoid arthritis, is given by intravenous infusion every 2 months.

Remicade was reported in this meeting as effective for treating JRA, thereby resulting in a significant and prompt reduction in disease activity and improved quality of life. Another paper presented data demonstrating that doses of Remicade that are higher than currently recommended doses could be effective and necessary in JRA.

Dr. Shiel's Perspective: This does not surprise me, since it is the same situation for adults with rheumatoid arthritis who are being treated in my practice.