Novel treatment options for juvenile idiopathic arthritis

Abstract

The purpose of this review is to summarize the newer and possible future treatments for the arthritis and systemic features in children with juvenile idiopathic arthritis (JIA), including evidence supporting their efficacy and safety.

Keywords:

• biologics
• juvenile idiopathic arthritis
• novel
• small molecules
• treatment

Financial & competing interests disclosure

N IIowite is a consultant for Novartis. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Key issues

• There have been dramatic improvements in treatment of both systemic and non-systemic juvenile idiopathic arthritis (JIA).

• While the American College of Rheumatology Pediatric 30 (Pedi 30) criteria are the primary outcome measure for improvement used in most clinical trials in JIA, the shift is now towards higher standards of response and clinical remission.

• TNF inhibitors are being recommended more readily than before, especially for patients with polyarticular JIA, enthesitis-related arthritis and sacroilitis.

• Tocilizumab is also being used to treat children with polyarticular JIA, in addition to systemic JIA.

• One of the benefits of JAK inhibitors is that they are orally available.

• Stem cell transplant has been successful in those with refractory disease.

• Biosimilars offer the potential for considerable cost savings; however, there remain concerns regarding their quality, immunogenicity, efficacy and toxicity.

Notes

Adapted from [2].

Adapted from [4].