JIA Medications Overview

By Robyn Abree | Updated April 27, 2022

Kids with juvenile idiopathic arthritis (JIA) have plenty of treatment options that can help control disease activity and get them back to doing the things they love. The type of medication or combination of medications your child takes depend on various factors including disease severity, type of JIA and the number of joints affected.

Medications to treat JIA fall into two categories: disease-modifying drugs and pain relievers.

Disease-Modifying Drugs

Disease-modifying drugs, which help control disease activity and slow disease progression, include:

• Disease-modifying antirheumatic drugs (DMARDs). These drugs help preserve joints by blocking inflammation.
  • Conventional DMARDs have a general immune-suppressing effect. The most prescribed conventional DMARD for children with arthritis is methotrexate.
  • Biologics, another type of DMARD, work to slow disease progression by targeting and suppressing a specific part of the immune system.
• Corticosteroids. These fast-acting anti-inflammatory and immunosuppressing drugs are usually only used in the short term. If your child only has a few involved joints, your child’s doctor may choose corticosteroid injections while waiting for other disease-modifying drugs to take effect. For kids with more severe disease and pain, they may be taken orally or through IV to treat body-wide (systemic) disease.

Pain Relievers

Your child’s doctor may also prescribe a pain reliever in addition to a disease modifying drug.

• NSAIDs. Over-the-counter and prescription nonsteroidal anti-inflammatory drugs (NSAIDS), such as ibuprofen (Advil, Motrin) and naproxen (Aleve), can help bring down inflammation and ease pain. Sometimes a prescription NSAID may be needed.
• Analgesics. Analgesics, like acetaminophen (Tylenol), can help relieve aches and pains, but do not impact inflammation.

FDA-Approved Drugs and Off-Label Use

The FDA has approved more than a dozen medications specifically for children with JIA. But those aren’t the only drugs your child’s doctor might prescribe. Pediatric rheumatologists have found some drugs approved for adults work well for kids, too. If the doctor prescribes a drug approved for adults for your child, a common practice called off-label use, the dosage may be adjusted for body weight.

FDA-APPROVED MEDS FOR KIDS

• Biologics: Abatacept, Adalimumab, Belimumab, Canakinumab, Etanercept, Golimumab, Secukinumab, Tocilizumab
• Corticosteroids: Prednisone
• NSAIDs: Celecoxib, Ibuprofen, Meloxicam, Naproxen, Tolmetin
• DMARDs: Methotrexate, Sulfasalazine
• Targeted Synthetic DMARD: Tofacitinib

COMMON MEDS USED OFF-LABEL FOR KIDS

• Biologics: Anakinra, Certolizumab, Infliximab, Rituximab, Ustekinumab
• DMARDs: Hydroxychloroquine, Leflunomide

Children have some of the same medication risks adults do, such as methotrexate-related liver problems. Others are unique to children, such as the potential for slowed growth with corticosteroids. Regular monitoring and communication with your child’s doctor can help reduce these risks.