الفهرس | Only 14 pages are availabe for public view |
Abstract Juvenile rheumatoid arthritis (JRA) is a group of diseases in children, which are all characterized by arthritis in at least one joint for a minimum of 6-weeks duration. The assumption that JRA will usually resolve by adulthood also was found to be incorrect. The goals of therapy of JRA are to decrease chronic joint pain, suppress the inflammatory process and prevent irreversible joint damage. Accomplishing these goals will lead not only to improved short-term and long-term function but also to normal growth and development. Major medications of treatment of JRA include non steroidal anti-inflammatory drugs (NSAIDs), corticosteroids whether systemic or intra-articular, disease modifying anti-rheumatic drugs (DMARDs) as methotrexate (MTX) which is considered the treatment cornerstone for most patients with JRA. leflunomide which is alternative to MTX and Sulfasalazine (SSZ) which in combination with other drugs (NSAIDs or DMARDs) is safe and effective in treatment of JRA . Antimalarials , Azathioprine (AZA) and Cyclosporine A (CSA) are also used as DMARDs in JRA . Biologic modifying agents includes anti-TNF-α as (etanercept, infliximab and adalimumab), anti IL-1 as (anakinra), anti-IL-6 as (tocilizumab), anti IL-2 as (daclizumab) and Cell targeted medications as rituximab and Abatacept. They are used as early as possible in refractory cases to protect joints from inflammatory destruction. |