Evolution of treatment options for juvenile idiopathic arthritis

Abstract

A recent study published in World J Clin Cases addressed the optimal non-steroidal anti-inflammatory drugs (NSAIDs) for juvenile idiopathic arthritis (JIA). Herein, we outline the progress in drug therapy of JIA. NSAIDs have traditionally been the primary treatment for all forms of JIA. NSAIDs are symptom-relief medications, and well tolerated by patients. Additionally, the availability of selective NSAIDs further lower the gastrointestinal adverse reactions compared with traditional NSAIDs. Glucocorticoid is another kind of symptom-relief medications with potent anti-inflammatory effect. However, the frequent adverse events limit the clinical use. Both NSAIDs and glucocorticoid fail to ease or prevent joint damage, and the breakthrough comes along with the disease-modifying antirheumatic drugs (DMARDs). DMARDs can prevent disease progression and reduce joint destruction. Particularly, the emergence of biologic DMARDs (bDMARDs) has truly revolutionized the therapeutics of JIA, compared with conventional synthetic DMARDs. As a newly developed class of drugs, the places of most bDMARDs in the management of JIA remain to be well established. Nevertheless, the continuous evolution of bDMARDs raises hopes of improving long-term disease outcomes for JIA.

Keywords: Juvenile idiopathic arthritis; Treatment; Non-steroidal anti-inflammatory drug; Disease-modifying antirheumatic drug; Evolution

Core Tip: In past decades, the pharmacological treatments for juvenile idiopathic arthritis (JIA) have undergone a dramatic evolution from non-steroidal anti-inflammatory drugs to disease-modifying antirheumatic drugs (DMARDs), especially the emergence of biologic DMARDs enable patients with refractory JIA to achieve disease remission. This editorial focuses on the progress in treatment options for JIA. We hope that this editorial could provide valuable information for use of anti-JIA drugs.