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Non‐steroidal anti‐inflammatory drugs and slow‐acting anti‐rheumatic drugs in juvenile rheumatoid arthritis
Author(s) -
FUJIKAWA SATOSHI
Publication year - 1993
Publication title -
pediatrics international
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 0.49
H-Index - 63
eISSN - 1442-200X
pISSN - 1328-8067
DOI - 10.1111/j.1442-200x.1993.tb03089.x
Subject(s) - medicine , sulfasalazine , methotrexate , rheumatoid arthritis , juvenile rheumatoid arthritis , naproxen , adverse effect , penicillamine , arthritis , rheumatic disease , antirheumatic drugs , pharmacology , antirheumatic agents , disease , alternative medicine , pathology , ulcerative colitis
The preferred drugs for the initial treatment of juvenile rheumatoid arthritis (JRA) are salicylates or other non‐steroidal anti‐inflammatory drugs (NSAID) such as tolmetin or naproxen. If the disease activity does not respond adequately to the treatment, slow‐acting anti‐rheumatic drugs (SAARD) such as oral gold agents, low‐dose D‐penicillamine, or sulfasalazine should be given in addition to NSAID. If the systemic manifestations are severe, corticosteroid therapy may be commenced. Furthermore, if the joint destruction is progressive, immunosuppressants such as methotrexate would be selected as the third‐line drugs of choice. The safety and efficacy of SAARD and immunosuppressants for the treatment of children with JRA, however, have not yet been confirmed, as the adverse effects such as bone marrow suppression, oncogenicity and mutagenicity are sometimes intense. Consequently, the strict indications for use and new therapeutic concepts for the management of JRA based on its pathogenesis are required.