Medical care of children with JRA must be provided in the context of a team-based approach, considering all aspects of their illness such as physical functioning in school and psychological adjustment to disease. Using medications in the absence of an appropriate physical therapy program and attention to problematic social issues of the family is not successful. Success of medications is monitored best with repeated physical examinations and history. Both the number of joints involved and the duration of morning stiffness should decrease with treatment. The outcome of treatment should be in the direction of stopping flare-ups as reflecting success.(10)
The healthcare team includes the following (10):
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Pediatric Rheumatologist who oversees the care of the child with JRA.
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Nurses who can help with education.
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Physical and Occupational Therapists whose therapies are an important part of treatment. Active programs such as exercises and stretching are recommended.
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Social Workers whose evaluation helps to determine how well each family is coping with their child's disease in terms of emotional and financial resources. Social workers can offer invaluable guidance for helping children to maintain healthy relationships within their families and at school.
A wide variety of medications are available to treat the childhood rheumatic diseases. The primary goal in using medications for children with rheumatic disease is to reduce inflammation, although many of the drugs used to reduce inflammation also help to reduce pain.
The medications used to treat the childhood rheumatic diseases are broadly classified as follows (6):
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Nonsteroidal anti- inflammatory drugs (NSAIDs), such as aspirin, ibuprofen and others.
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Slow- acting antirheumatic drugs (SAARDs) .
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Immunosuppressive agents such as methotrexate.
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Corticosteroids such as prednisone.
Here is a link to a table of Range of Available Juvenile Rheumatoid Arthritis Medication for Children (1) from Arthritis.org.
