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The choices of drugs for children with JIA are similar to those for adult arthritis. They include non-steroidal anti-inflammatory agents such as ibuprofen, and slower acting agents such as methotrexate, sulfasalazine and hydroxychloroquine for more severe cases.
It is important to adjust the doses of these drugs for the size of the child. It may be preferable to prescribe liquid preparations or give less frequently dosed medications to improve compliance.
Certain drugs such as steroids (cortisone) must be used with caution because of adverse effects on growth and other side effects. Methotrexate can be given either as an injection or as a tablet.
Newer medications
A newer class of medication called Biologics have proven to be effective in most forms of JIA. Biologics are medicines that block specific receptors or cytokines (chemical messengers) that promote inflammation in the joints.
The most frequently used biologics block a chemical known as TNFα (Tumour Necrosis Factor alpha). These medications are very expensive and may only be prescribed by a paediatric rheumatologist or adult rheumatologist in specific situations where other medications have not proven beneficial.
These agents are either given as subcutaneous or intravenous injections.
Other treatment
Physical and occupational therapy can prevent disability. Splints, a regular home exercise programme, or outpatient treatment is often effective.
Children should participate in regular school activities, extracurricular activities and family responsibilities as much as possible.
Revised and reviewed by Dr Chris Scott, Paediatric Rheumatologist, Red Cross Children’s Hospital, Cape Town February 2015.
