Disease-Modifying Antirheumatic Drugs in Children With Juvenile Idiopathic Arthritis
Head-to-Head Studies of DMARDs in This Review
A few head-to-head studies of DMARDs in JIA treatment have been performed. NSAIDs and corticosteroids were permitted for both treatment and control groups. The direct comparisons to date included D-penicillamine versus hydroxychloroquine in two studies. Both studies allowed NSAIDs and prednisone as other treatments for symptoms. The first study included 41 patients with pauciarticular disease and 31 patients with polyarticular disease at onset. The second study included 142 patients with polyarticular disease, 11 with pauciarticular disease, and 9 with systemic disease. One study compared sulfasalazine with hydroxychloroquine; NSAIDs and prednisone were used as additional treatments for symptoms. The study population included 12 patients with oligoarticular disease, 23 with polyarticular disease, and 3 with systemic disease at onset. Leflunomide was compared with methotrexate in one study; other allowed treatments were NSAIDS, prednisone, and intra-articular corticosteroids. The study population included 94 patients with polyarticular disease. Etanercept and infliximab were compared in one study that also allowed methotrexate (MTX), prednisolone, sulfasalazine, intra-articular corticosteroids; NSAIDs were used as additional treatment for symptoms. The study population included 24 patients with polyarticular disease at onset.
Keywords: juvenile idiopathic arthritis | JIA | JRA | juvenile rheumatoid arthritis | JCA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | TNF-alpha blockers | biologic DMARD | nonbiologic DMARD | non-biologic DMARD | D-penicillamine | hydroxychloroquine | sulfasalazine | leflunomide | methotrexate | etanercept | infliximab | polyarticular | pauciarticular | systemic onset | oligoarticular
- Kemper A, Coeytaux R, Sanders G, et al. Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA). Comparative Effectiveness Review No. 28 (Prepared by the Duke Evidence-based Practice Center under Contract No. HHSA 290-2007-10066-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC039-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsjia.cfm.
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