Treatment strategies for juvenile idiopathic arthritis.
BACKGROUND
Treatment of juvenile idiopathic arthritis has markedly improved in the last decade and induction of remission became a reachable goal.


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


RESULTS
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.
Klein
Ariane
A
Asklepios Clinic Sankt Augustin, Department of Pediatrics, Germany.
Horneff
Gerd
G
D000293:Adolescent; D000818:Animals; D001171:Arthritis, Juvenile / Q000150:complications / Q000188:drug therapy* / Q000628:therapy; D002648:Child; D002675:Child, Preschool; D002986:Clinical Trials as Topic; D006801:Humans; D010146:Pain / Q000188:drug therapy / Q000209:etiology