Disease-Modifying Antirheumatic Drugs in Children With Juvenile Idiopathic Arthritis
Specific Findings About Adverse Effects
Reported rates of adverse effects are similar between DMARDs and placebo in nearly all published randomized controlled trials.
Methotrexate is associated with more laboratory abnormalities than are other DMARDs. Combination therapy with infliximab and methotrexate is associated with more serious adverse effects and infections than are other DMARDs.
Two publications surveying the world literature identified 66 cases of malignancy in children with JIA treated with TNF-α–blocking DMARDs.
In this effectiveness review, 11 cases of malignancy were identified in more than 4,000 patient reports.
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 | adverse effects
- 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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