Treatment strategies for juvenile idiopathic arthritis

Expert Opin Pharmacother. 2009 Dec;10(18):3049-60. doi: 10.1517/14656560903386300.

Abstract

Importance of the field: Treatment of juvenile idiopathic arthritis has markedly improved in the last decade and induction of remission became a reachable goal.

Areas covered in this review: For this review the current literature about clinical trials in JIA is summarized including those substances and strategies currently not approved for treatment.

What the reader will gain: With this information, the reader receives an overview on the current available treatment options and will be enabled to guide modern treatment of the several JIA subgroups. Take home messages: Current treatment strategies in juvenile idiopathic arthritis (JIA) - including conventional and new therapeutics, biologics - have changed the outcome of JIA. Treatment with TNF inhibitors lead to a rapid and sustained suppression of inflammation and can effectively be used for treatment of polyarticular JIA. Blockers to further pro-inflammatory cytokines, IL-1 and IL-6 are most valuable for treatment of systemic-onset JIA. Blockers of T-cell activation are an alternative approach, slowly acting but targeting to complete inactivation of the disease. Future concepts for the post-biologics era of treatment of rheumatic diseases use antigen-specific tolerance induction and modulation of the immune response. Clinical remission has now become a reachable target in the treatment of JIA.

Publication types

  • Review

MeSH terms

  • Adolescent
  • Animals
  • Arthritis, Juvenile / complications
  • Arthritis, Juvenile / drug therapy*
  • Arthritis, Juvenile / therapy
  • Child
  • Child, Preschool
  • Clinical Trials as Topic
  • Humans
  • Pain / drug therapy
  • Pain / etiology