Juvenile idiopathic arthritis

Updated: August 31, 2022

Background

Epidemiology

Anatomy

Pathophysiology

Etiology

Genetics

Prognostic Factors

Clinical History

Physical Examination

Age group

Associated comorbidity

Associated activity

Acuity of presentation

Differential Diagnoses

Laboratory Studies

Imaging Studies

Procedures

Histologic Findings

Staging

Treatment Paradigm

by Stage

by Modality

Chemotherapy

Radiation Therapy

Surgical Interventions

Hormone Therapy

Immunotherapy

Hyperthermia

Photodynamic Therapy

Stem Cell Transplant

Targeted Therapy

Palliative Care

Medication

auranofin

0.1 mg/kg/day orally in divided doses
Maintenance dose- 0.15 mg/kg orally each day or divided twice daily Do not exceed more than 0.2 mg/kg/day orally each day as divided twice daily

tolmetin

For more than 2 Years:
Initial dose of 20 to 30 mg/kg/day given orally divided into every 6 to 8 hours
Maintenance dose of 15-30 mg/kg/day divided into every 6 to 8 hours
For less than 2 years:
Safety and efficacy not determined

tocilizumab

Recommended for the treatment of active systemic juvenile idiopathic arthritis (SJIA) in patients who are 2 years of age or older

It can be administered intravenously (IV) or subcutaneously (SC) either as a standalone treatment or in combination with methotrexate
For patients <2 years old, the safety and effectiveness of this medication have not been established
It is also not advisable for patients with an ANC (absolute neutrophil count) less than 1,000/mm3, a platelet count below 50,000 mm3, or ALT/AST levels exceeding 10 times the upper limit of normal

The recommended dosages are as follows:

IV infusion for patients aged 2 years and older:
For those weighing less than 30 kg, the dosage is 12 mg/kg IV every 2 weeks
For those weighing 30 kg or more, the dosage is 8 mg/kg IV every 2 weeks

SC injection for patients aged 2 years and older:
For those weighing less than 30 kg, the recommended dose is 162 mg SC every 2 weeks
For those weighing 30 kg or more, the dosage is 162 mg SC weekly