Current treatment of juvenile rheumatoid arthritis

Norman T. Ilowite

Research output: Contribution to journalArticlepeer-review

116 Scopus citations


Prognostic factors in juvenile rheumatoid arthritis (JRA) include polyarticular onset, polyarticular disease course, and rheumatoid factor positivity; in the systemic onset subtype, persistence of systemic features at 6 months after onset confers a worse prognosis. Timely diagnosis and appropriate aggressive treatment of patients with poor prognostic features improve quality of life and outcome. After nonsteroidal anti-inflammatory drugs, methotrexate is the most commonly used second-line agent. However, approximately one third of patients do not respond to methotrexate adequately. Randomized, placebo-controlled, clinical trials in patients with JRA are few, but one such trial with the tumor necrosis factor inhibitor etanercept shows that this drug is effective and well-tolerated. Other recently approved agents for rheumatoid arthritis, including infliximab, leflunomide, celecoxib, and rofecoxib, have not been adequately studied in pediatric patients, and the role of these agents in children with JRA remains to be determined.

Original languageEnglish (US)
Pages (from-to)109-115
Number of pages7
Issue number1
StatePublished - 2002
Externally publishedYes


  • Antirheumatic agents
  • Disease-modifying antirheumatic drugs
  • Tumor necrosis factor

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health


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