Journal
EXPERT OPINION ON PHARMACOTHERAPY
Volume 10, Issue 18, Pages 3049-3060Publisher
TAYLOR & FRANCIS LTD
DOI: 10.1517/14656560903386300
Keywords
abatacept; adalimumab; anakinra; canakinumab; etanercept; infliximab; juvenile idiopathic arthritis; leflunomide; methotrexate; tocilizumab
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Importance of the field: Treatment of juvenile idiopathic arthritis has markedly improved in the last decade and induction of remission became a reachable goal. Areas covered in this review: For this review the current literature about clinical trials in JIA is summarized including those substances and strategies currently not approved for treatment. What the reader will gain: With this information, the reader receives an overview on the current available treatment options and will be enabled to guide modern treatment of the several JIA subgroups. Take home messages: Current treatment strategies in juvenile idiopathic arthritis (JIA) - including conventional and new therapeutics, biologics - have changed the outcome of JIA. Treatment with TNF inhibitors lead to a rapid and sustained suppression of inflammation and can effectively be used for treatment of polyarticular JIA. Blockers to further pro-inflammatory cytokines, IL-1 and IL-6 are most valuable for treatment of systemic-onset JIA. Blockers of T-cell activation are an alternative approach, slowly acting but targeting to complete inactivation of the disease. Future concepts for the post-biologics era of treatment of rheumatic diseases use antigen-specific tolerance induction and modulation of the immune response. Clinical remission has now become a reachable target in the treatment of JIA.
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