Juvenile rheumatoid arthritis (JA) is a chronic condition that causes inflammation in one or more joints, and begins before the age of 16.
The diagnosis and treatment of the condition, also called childhood arthritis or juvenile idiopathic arthritis, must be by a rheumatologist or paediatric rheumatologist familiar with the most recent treatments choices.
JA is sub-classified into groups of patients who have:
- A systemic onset (with fever and other symptoms beyond joint involvement)
- Those with multiple or only a few joints and/or tendons involved
- Those with mainly spinal involvement
- Those with underlying inflammatory bowel disease or psoriasis of the skin or nails
It is vital to treat joint involvement as soon as possible to prevent permanent damage, contractions and deformities.
Drugs of choice for the joints are usually methotrexate (Methotrexate Ebewe) or sapropterin (Salazopyrin) singularly or in combination. If the arthritis persists or there is ongoing disease activity, a biologic agent is recommended, e.g. etanercept (Enbrel), adalimumab (Humira), abatacept (Orencia), tocilizumab (Actemra) or rituximab (Mabthera).
Adjuvant treatment such as short-term cortisone, anti-inflammatories and analgesics are used as needed for pain and stiffness.
Physical and occupational therapy can help to prevent disability and assist with pain reduction by way of splints etc.
Children should be encouraged to continue with school and sporting activities as much as possible once the disease is controlled.
The diagnosis and treatment of the condition, also called childhood arthritis or juvenile idiopathic arthritis, must be by a rheumatologist or paediatric rheumatologist familiar with the most recent treatments choices.
JA is sub-classified into groups of patients who have:
- A systemic onset (with fever and other symptoms beyond joint involvement)
- Those with multiple or only a few joints and/or tendons involved
- Those with mainly spinal involvement
- Those with underlying inflammatory bowel disease or psoriasis of the skin or nails
It is vital to treat joint involvement as soon as possible to prevent permanent damage, contractions and deformities.
Drugs of choice for the joints are usually methotrexate (Methotrexate Ebewe) or sapropterin (Salazopyrin) singularly or in combination. If the arthritis persists or there is ongoing disease activity, a biologic agent is recommended, e.g. etanercept (Enbrel), adalimumab (Humira), abatacept (Orencia), tocilizumab (Actemra) or rituximab (Mabthera).
Adjuvant treatment such as short-term cortisone, anti-inflammatories and analgesics are used as needed for pain and stiffness.
Physical and occupational therapy can help to prevent disability and assist with pain reduction by way of splints etc.
Children should be encouraged to continue with school and sporting activities as much as possible once the disease is controlled.