Juvenile Arthritis - Treatments

Not ready to share? Read other Patient Comments

What was the treatment for your juvenile idiopathic arthritis/juvenile rheumatoid arthritis?

Share your story with others:

MedicineNet appreciates your comment. Your comment may be displayed on the site and will always be published anonymously.Patient Comments FAQs

Enter your Comment

Tell us a bit about your background to make your comments more useful to other MedicineNet users. (Optional)

Screen Name: *

Gender of Patient: Male Female

Age Range of Patient:

I am a: Patient Caregiver


* Screen Name will appear next to the published comment. Please do not include your full name or email address.

By submitting your comment, and other materials (collectively referred to as a "Submission") to MedicineNet, you grant MedicineNet permission to use, copy, transmit, publish, display, edit and modify your Submission in connection with its Web site. MedicineNet will not pay you for your Submission. You represent that you have all rights necessary for MedicineNet to use your Submission as set forth above.

Please keep these guidelines in mind when writing your comment:

  • Please make sure you address the question asked.
  • Due to the overwhelming number of comments received, not all comments will be published.
  • When selecting comments to publish, our staff will choose those that are educational and complement the topic. Please try to stay on topic.
  • Your comment may be edited. We would typically edit comments to make them clearer and more readable. We will remove personal information such as last names, email and web addresses, and other potentially harmful information.
  • We will not notify you if your comment has been published. We suggest that you check back on the topic article regularly.
  • We do not provide medical or healthcare advice, treatment, or diagnosis.

Thank you for participating!


I have read and agree to abide by the MedicineNet Terms and Conditions and the MedicineNet Privacy Policy (required).

To prevent our systems from spam, please complete the following prior to submitting your comment.

Please select the black square:

What is the treatment for juvenile idiopathic arthritis (JIA)/juvenile rheumatoid arthritis (JRA)? What medications treat JIA/JRA?

While there currently is no cure for JIA, an integrated and coordinated approach has been shown to be helpful in lessening the morbidity (nonlethal side effects) of JIA. Goals include lessening pain, joint contractures, and growth disturbances (see above). Monitoring for the development of iritis and aggressive treatment are also paramount. Often patients are best served at a pediatric teaching hospital where access to pediatric rheumatologists, physical and occupational therapists, pharmacologists, and social support providers may allow "one stop shopping."

Therapies for JIA patients include the following:

1. Nonsteroidal anti-inflammatory drugs (NSAIDs) are commonly used as the first line of therapy due to their positive effect of reducing inflammation in arthritis and relatively few side effects. Medications such as ibuprofen (Advil, Motrin), naproxen (Aleve), and indomethacin (Indocin) are examples of this class of therapy.

2. Steroids are another common class of medications for those experiencing moderate to severe arthritis or nonarthritis inflammatory consequences of JIA. These medications may be administered orally (prednisone [Deltasone], prednisolone [Pediapred]), intravenously (methylprednisolone [Solu-Medrol], dexamethasone [Decadron], hydrocortisone [Solu-Cortef]), or injected directly into an involved joint (methylprednisolone [Depo-Medrol], triamcinolone [Kenalog]). Side effects of steroids may be considerable, and pediatric rheumatologists strive to use the lowest possible dosage. Side effects are most commonly seen at dosages over 20 mg/day and may include immune system depression, increased appetite resulting in weight gain, acne, mood changes, osteoporosis, bruising, cataracts, glaucoma, and diabetes.

3. Antirheumatic medications (also known as disease-modifying antirheumatic drugs or DMARDs) are needed in approximately two-thirds of children to control the joint changes and prevent damage of JIA. These medications are generally considered when the medications previously described are not providing effective control of the illness. Medicines in this category include methotrexate (Trexall), now considered the "gold standard" for JIA, sulfasalazine (Azulfidine), azathioprine (Imuran), cyclosporine (Sandimmune, Neoral), and others. These medications are administered orally or intravenously. Antirheumatic medications are more potent in effect but also can have significant side effects. All of these medications require regular blood testing to monitor for side effects. Problems include immune suppression, which may cause an increased risk of infection, certain cancers, bone marrow toxicity, pulmonary toxicity, liver function abnormalities, abdominal pain, and decrease in appetite.

4. Biologic agents can lessen the morbidity for children with JIA. These agents are administered either by superficial injection under the skin or intravenously. Their general chemical classification is that of "monoclonal antibodies" that work by accurately targeting various mechanisms of the immune system that are overactive and misdirected in JIA. They are associated with an increased risk of infections and (rarely) development of certain malignancies. As such, close clinical monitoring and various laboratory studies are required. Examples of biologics used in the treatment of JIA include etanercept (Enbrel), anakinra (Kineret), adalimumab (Humira), tocilizumab (Actemra), and abatacept (Orencia).

5. Autologous stem cell transplantation is reserved only for those children with JIA who have failed the above therapeutic options. This procedure requires hospitalization and is a two-step process. The initial portion is utilization of high-dose immune suppression medications to remove the patient's lymphocytes (a type of white blood cell) that are attacking the patient's joint(s). Once removed, new stem cells from the patient (autologous) that were previously harvested and treated are introduced back into the patient's body via the bloodstream. This process requires expertise found only in a few pediatric referral centers.

Return to Juvenile Idiopathic Arthritis (Juvenile Rheumatoid Arthritis)

See what others are saying

Comment from: MissyAubs, 19-24 Female (Patient) Published: April 16

AT the age of 15 they put me on Enbrel for juvenile arthritis.

Was this comment helpful?Yes

STAY INFORMED

Get the latest health and medical information delivered direct to your inbox!