Current management of juvenile idiopathic arthritis.
The goal of juvenile idiopathic arthritis (JIA) treatment is to achieve remission of disease. The absence of a full understanding of the disease pathogenesis for JIA hinders the development of truly effective treatment approaches. Further, the lack of clear knowledge regarding the mechanisms of action of rheumatologic medications and the existence of few randomized controlled trials leaves clinicians with very little evidence upon which to base decisions regarding the best timing, dosages or combinations of medications to be used for fully effective treatment of JIA. There is now a shift in treatment focus from that of chasing failure (gradual add-on approach to the use of medications) to one of early aggressive combination treatment. This chapter will discuss the current approaches to medical management of JIA and the medications currently available for use. JIA treatment is a vast, rich area in need of research.
Wallace
Carol A
CA
Division of Immunology, Rheumatology and Infectious Diseases, Children's Hospital and Regional Medical Center, University of Washington School of Medicine, 4800 Sandpoint Way NE MS-B-6583, Seattle, WA 98105, USA. cwallace@u.washington.edu
D000293:Adolescent; D000367:Age Factors; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000627:therapeutic use; D001171:Arthritis, Juvenile / Q000175:diagnosis / Q000628:therapy*; D001688:Biological Products / Q000627:therapeutic use; D002648:Child; D002675:Child, Preschool; D018450:Disease Progression; D004359:Drug Therapy, Combination; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007166:Immunosuppressive Agents / Q000627:therapeutic use*; D008134:Long-Term Care; D008297:Male; D017410:Practice Guidelines as Topic; D018570:Risk Assessment; D012720:Severity of Illness Index; D033581:Stem Cell Transplantation / Q000379:methods*; D014182:Transplantation, Autologous; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D001688:Biological Products; D007166:Immunosuppressive Agents