Treatment Options for Juvenile Arthritis

Children with different types of juvenile idiopathic arthritis have different symptoms, and these vary from one child to another. But no matter what type of JIA your child has, the overriding goal is the same- ridding the inflammation as rapidly as possible to give your child's joints and bones the possible best chance to develop normally.

Medical treatment for JIA often starts with drugs called nonsteroidal anti-inflammatory drugs, which help relieve symptoms such as pain, swelling and stiffness. Among the most common NSAIDs are ibuprofen and naproxen, in therapeutic doses. Most children with JIA need medication and physical therapy to reach these goals.

Disease-modifying anti-rheumatic drugs are often used if NSAIDs don't provide sufficient relief. DMARDs slow the progression of JIA, but because they take weeks or months to relieve symptoms, they often are taken with an NSAID. Methotrexate is usually the main DMARD used for juvenile arthritis.

Corticosteroids, such as prednisone, may be used in children with severe juvenile arthritis. These drugs can help stop serious symptoms such as inflammation of the lining around the heart. Steroids can be given either directly into the vein, into joints, or by mouth. Steroids can interfere with a child's normal growth and can cause other side effects, such as a round face, weight gain, weakened bones, and increased susceptibility to infections.

Because juvenile arthritis is caused by an overactive immune system, medications that suppress the immune system can help. Examples include abatacept (Orencia), rituximab (Rituxin), anakinra (Kineret) and tocilizumab (Actemra). Immune suppressants increase the risk of infections and, rarely, some types of cancer.

Your doctor may recommend that your child work with a physical therapist to help keep joints flexible and maintain range of motion and muscle tone. A physical therapist or an occupational therapist may make additional recommendations regarding the best exercise and protective equipment for your child. A therapist may also recommend that your child make use of joint supports or splints to help protect joints and keep them in a good functional position.

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