Management of Juvenile Idiopathic Arthritis in Adolescents.

ABSTRACT

Many terms are used to describe juvenile rheumatoid arthritis and the term most used today is JIA or juvenile idiopathic arthritis. JIA is the most common rheumatoid disorder occurring in 0.5-2.0/1,000 children and adolescents. It is typically divided into oligoarticular, polyarticular (RF-positive and RF-negative) and systemic-onset (Stills disease). The laboratory testing is nonspecific and there is no single test or combination of tests that are pathognomonic for JIA. This discussion focuses on management of JIA that centers on nondrug treatment and drug treatment. JIA pharmacology centers on NSAIDs, corticosteroids, DMARDs (especially methotrexate) and if available various cytotoxic agents and biologic response modifiers. The proper use of nonpharmacologic and pharmacologic management can control pain, reduce inflammation as well as joint damage and improve the quality-of-life for adolescents with JIA.