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    Juvenile Idiopathic Arthritis: Features of DMARD and SSARD Drugs

    Juvenile Idiopathic Arthritis: Features of DMARD and SSARD Drugs

    Topic Overview

    Children who have juvenile idiopathic arthritis (JIA) are first treated with nonsteroidal anti-inflammatory drugs ( NSAIDs ) that often provide relief and reduce inflammation. NSAIDs are considered the first-line treatment for JIA. Second-line drug therapy?known interchangeably as disease-modifying antirheumatic drugs (DMARDs) and as slow-acting antirheumatic drugs (SAARDs)?for JIA may be recommended when a child continues to have joint pain, swelling, or both despite rest, exercise, use of NSAIDs, and physical therapy.

    DMARDs/SAARDs include azathioprine, cyclosporine, etanercept, methotrexate, and sulfasalazine.

    DMARDs/SAARDs have a lot in common.

    • They are slow to take effect. It may take 8 to 24 weeks for the drug to show a benefit.
    • They have a small risk of serious side effects (on blood cells, eyes, kidney, or liver). Side effects can be detected with close monitoring and are reversible if the drug is stopped.
    • They have a moderate risk of side effects that may be uncomfortable but are not serious (nausea, skin rash, mouth sores, diarrhea, hair thinning).
    • While these medicines offer effective treatment for many children, they are not a reasonable treatment option for others. Side effects or ineffectiveness, or both, are common reasons that children are withdrawn from DMARD/SAARD treatment.
    • NSAIDs are often used together with one of these medicines.

    Although these medicines are often called "disease-modifying," it has been hard to prove that they truly prevent long-term joint damage. But they often relieve pain and swelling.

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    Credits

    By Healthwise Staff
    Primary Medical Reviewer Susan C. Kim, MD - Pediatrics
    Specialist Medical Reviewer John Pope, MD - Pediatrics
    Last Revised June 5, 2012

    Last Revised: June 5, 2012

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