Efficacy of non-steroidal anti-inflammatory drug monotherapy in children with systemic juvenile idiopathic arthritis

Excerpt

Treatment of systemic juvenile idiopathic arthritis (sJIA) is one of the most challenging tasks faced by pediatric rheumatologists. Traditionally, many pediatric rheumatologists have used a “pyramid” approach, starting with non-steroidal anti-inflammatory drug (NSAID) monotherapy prior to the initiation of disease modifying anti-rheumatic drugs (DMARDs) or biologic agents. Despite the widespread use of NSAID monotherapy, the likelihood of response to this regimen has not been well characterized. In addition, some clinicians have recently begun to advocate for the use of biologic agents as first-line therapy for all patients with sJIA, despite the risks of patient discomfort, infection, and malignancy that may be associated with their use. The goals of this study are (1) to determine the frequency of clinical response to NSAID monotherapy in sJIA, and (2) to identify factors that predict that response. …