POLYARTICULAR JUVENILE IDIOPATHIC ARTHRITIS - PREVENTION OF CHRONIC JOINT DAMAGE
DOI:
https://doi.org/10.46793/PP170204005LKeywords:
juvenile idiopathic arthritis, polyarticular juvenile idiopathic arthritis, treatmentAbstract
Polyarticular juvenile idiopathic arthritis (pJIA) is defined as arthritis affecting more than 5 joints in the first six months of the disease. According to the rheumatoid factor (RF) positivity we recognize RF positive JIA and RF negative JIA. Clinical presentation of these subtypes is similar, but they differ in clinical course and outcome. RF positive pJIA patients tend to have worse outcome than RF negative pJIA patients with early appearance of joint damage, why more aggressive treatment approach is needed. JIA etiopathogenesis novelties and genetic engineering improvement provided new treatment strategies which have resulted in better disease course and clinical outcome. The main goal of this new therapeutical approach is to ensure good quality of life, to reduce disease activity, to optimize children growth, preserve joint functional activity, prevent joint damage, as well as physical and working disability. Individualized treatment approach depends on pJIA subtype and presence of poor prognostic factors. It represents combination of anti-inflammatory and immunomodulatory drugs followed with continuous occupational treatment. pJIA patients require earlier and more aggressive treatment with metotrexate and biological treatment commencement, especially if there is not adequate response on metotrexate treatment. One decade positive experience with biological treatment at our department had shown therapy efficacy and safety in the youngest population, which is in concordance with finding among other European contries.
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