Treatment of Juvenile Arthritis
December 13th, 2011 | 
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The main goal of treatment is to control inflammation to stop joint damage and to control symptoms so that the child can have a good quality of life. Nonsteroidal anti-inflammatory drugs (NSAIDs) are usually the first drugs prescribed to relieve inflammation in the joints. This decreases the amount of an enzyme found in affected joints that stimulate inflammation.
This same enzyme, however, helps protect the stomach, so NSAIDs often cause stomach irritation and ulcers. Available low-dose non-prescription NSAIDs, including ibuprofen (Advil, Motrin and other brands) and naproxen (Naprosyn, Aleve and others). Celecoxib (Celebrex) is a new drug, called COX-2 inhibitor is believed to be safer for the stomach because it has much effect on the enzyme that protects the stomach.
In moderate to mild cases, children with juvenile arthritis may be treated with more potent drugs or a combination of medicines. Corticosteroids (prednisone) are fast-acting anti-inflammatory agents that could be used to stop dangerous inflammation, such as the lining of the heart is inflamed (pericarditis) or to stabilize a child in an acute stage of the disease . These medications can have serious side effects such as weight gain, weak bones, more susceptibility to infection and interference with growth. These medications are usually prescribed for a short period and should be taken exactly as prescribed by your doctor.
Other drugs, called anti-rheumatic drugs that modify the disease (DMARD), such as methotrexate (Rheumatrex and others) act slowly, but often provide relief if other medicines do not work. These can cause liver damage or other complications, so the doctor will monitor carefully the blood in children taking DMARDs. May be beneficial medications such as hydroxychloroquine (Plaquenil), sulfasalazine (Azulfidine), leflunomide (Arava), azathioprine (Imuran) and cyclosporine (Neoral, Sandimmune). Thalidomide may be beneficial in some children with JRA (juvenile rheumatoid arthritis), however, women should avoid becoming pregnant while taking this medication, and can also cause nervous system damage. Newer injectable treatments, including adalimumab (Humira) and etanercept (Enbrel) were recently approved for juvenile rheumatoid arthritis. Infliximab (Remicade) and anakinra (Kineret) can also be very effective in some children with juvenile rheumatoid arthritis.
Sometimes surgery is necessary if joint damage is severe or is there joint deformity.
Encouragement should be given to children with juvenile arthritis to lead as normal a life as possible. Although it may cause pain, physical exercises are important because they help keep the joints moving. Once symptoms are controlled, want your child to participate in their usual games and sports activities. In severe cases, doctors may recommend physical therapy to keep joints moving. May also be needed specialized care guardians or teachers if the child misses many weeks of school because of illness. It could also recommended to help the child deal with emotional issues that cause a prolonged illness.
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