By Rosanna Sutherby, PharmD
July is Juvenile Arthritis Awareness Month. An estimated 300,000 children in the United States have some type of juvenile arthritis (JA). The most common of these is juvenile idiopathic arthritis.
What Is Juvenile Arthritis?
Juvenile arthritis is an autoimmune disorder that occurs in children 16 years or younger. This means that the body’s immune system attacks its own healthy cells. It is characterized by joint pain, swelling, stiffness, and loss of motion. Symptoms can range from mild to severe enough to cause joint or tissue damage.
Some children may have one or two flare-ups in their lifetime, while others may have symptoms for years. The most common type of JA is juvenile idiopathic arthritis. “Idiopathic” means that the cause is not known.
Scientists believe that some children have a gene that makes them more likely to develop JA. Exposure to environmental factors, such as a virus or bacteria, triggers the disease to appear. Most cases of JA are not hereditary, which means that it does not run in families.
Prescribed a medication for Juvenile Arthritis?
How Do You Diagnose Juvenile Arthritis?
Diagnosing JA can be tricky because the symptoms resemble other conditions. The following tests help your child’s doctor rule out other disorders:
- Blood tests
- Medical history
- Physical exam
To diagnose JA, the child must have arthritis symptoms for six consecutive weeks, and the symptoms must have appeared by the age of 16.
What Are the Signs and Symptoms of Juvenile Arthritis?
Often, the first sign of JA is a morning limp that is caused by an inflamed knee. Other symptoms of the disease include:
- Joint pain
- Loss of appetite
- Eye inflammation
- Difficulty doing daily activities, such as walking, dressing, or playing
How Do You Treat Juvenile Arthritis?
The goal of juvenile arthritis treatment is to help your child maintain normal physical activity and social functioning. To do this, your child’s doctor will use a combination of treatments that reduce pain and swelling, maintain full movement and strength of the joints, and prevent complications or joint damage.
The most significant part of treatment for JA is medication. Commonly used drugs include the following:
- Nonsteroidal anti-inflammatory drugs (NSAIDs): Typical NSAIDs used to relieve pain and swelling include ibuprofen (Advil, Motrin, and others) and naproxen (Naprosyn, Aleve).
- Disease-modifying antirheumatic drugs (DMARDs): The most commonly used DMARD is methotrexate. Your child’s doctor may prescribe methotrexate if NSAIDs do not relieve his or her symptoms. Methotrexate may be used in combination with NSAIDs to slow the progression of the disease.
- Biologic agents: Biologic agents, or biologic response modifiers, are a new class of drugs made from living cells. Some medications, such as Enbrel (etanercept) and Humira (adalimumab), work by blocking the action of tumor necrosis factor (TNF). TNF is a protein in your body that causes inflammation. Other biologic agents, such as Orencia (abatacept), Rituxan (rituximab), Kineret (anakinra), and Actemra (tocilizumab), work by suppressing your immune system.
- Corticosteroids: Corticosteroids, such as prednisone, may treat severe symptoms, such as inflammation of the sac around the heart. Steroids can interfere with your child’s growth, so they should be used only for a short time.
What Can You Do at Home?
Family members and parents can play a significant role at home in helping children live with JA. The following are ways in which you can be involved in your child’s treatment:
- Make sure your child gets regular exercise to build muscle strength and maintain joint flexibility. Encourage them to participate in physical activities and sports, especially during symptom-free periods. Be sure to adhere to recommendations from your child’s doctor or physical therapist.
- Apply a hot pack or have your child take a warm bath or shower to relieve stiffness, especially in the morning.
- Maintain a healthy diet for your child. Some children may lose their appetite, and others may gain weight due to medication side effects.
- Treat your child as you would treat other children in your household. Treating your child as normally as possible encourages responsibility and independence on his or her part.
- Allow your child to express their feelings about having JA. Explain to them that the disease is not their fault.
- Work closely with teachers and administrators at your child’s school to help develop plans for the best way for your child to navigate classes and assignments.
Will My Insurance Pay for My Child’s Juvenile Arthritis Medication?
Generic medications, such as methotrexate and prednisone, are generally covered by most insurance plans. Some plans may not cover medicines that are available over the counter, such as ibuprofen or naproxen. Biologic agents, such as Enbrel, Humira, Orencia, Rituxan, Kineret, and Actemra, may be costly. Your plan may require prior authorization before covering them.
If your insurance does not cover your child’s medication or the cost is too high, you can use a prescription savings card to get the lowest prescription price at a pharmacy near you. Be sure to compare prescription prices and use your free RX savings card before filling your child’s JA medication.
Rosanna Sutherby is a freelance medical writer who has been a practicing pharmacist in her community for close to 20 years. She obtained her Doctor of Pharmacy from Nova Southeastern University in Ft. Lauderdale, FL. She utilizes her clinical training in the pharmacy, where she helps patients manage disease states such as asthma, diabetes, heart disease, hypertension, and many others. Dr. Sutherby reviews and recommends drug regimens based on patients’ concurrent conditions and potential drug interactions.