[Drug treatment of juvenile chronic arthritis]

Medical therapy is an important component of the management of children with juvenile chronic arthritis, which should involve a multidisciplinary approach. NSAID's are the most important drugs in the treatment of JCA. Apart from salicylates a wide variety of NSAID's is now available, which have proven to be safe and effective for children with JCA. Medical treatment with NSAID's alone is satisfactory in most cases, especially the mono- and oligoarticular subtypes. Intra-articular corticosteroid injections in mono- and pauciarticular JCA have show to be a safe and highly efficacious form of treatment. Disease modifying antirheumatic drugs (DMARD's) are indicated for progressive polyarthritis unresponsive to NSAID's. More controlled clinical trials are needed to clarify the place of these drugs in the treatment of JCA. For the seropositive erosive polyarthritis institution of DMARD's early in the disease is generally accepted. The first experiences with methotrexate are promising for treatment of the more severe cases.