Biologic Response Modifiers (TNF Inhibitors)
Children with polyarticular
juvenile rheumatoid arthritis who have received little relief from other drugs may be given one of a new class of drug treatments called biologic response modifiers.
Etanercept (
Enbrel®), for example, is such a medicine. It blocks the actions of tumor necrosis factor (TNF), a naturally occurring protein in the body that helps cause inflammation. For this reason, Enbrel is also part of a class of medicines called TNF inhibitors (which is considered a subclass of biologic response modifiers).
The Importance of Exercise and Physical Therapy
Exercise is an important part of a child's treatment plan. It can help to maintain muscle tone and preserve and recover the range of motion of the joints. In fact, the more active a child is, the better his or her prognosis.
A physiatrist (rehabilitation specialist) or a physical therapist can design an appropriate exercise program for a person with juvenile
rheumatoid arthritis. The specialist may also recommend using splints and other devices to help maintain normal bone and joint growth.
Who Treats Juvenile Rheumatoid Arthritis?
The special expertise of rheumatologists in caring for patients with juvenile rheumatoid
arthritis is extremely valuable. Pediatric rheumatologists are trained in both pediatrics and rheumatology and are best equipped to deal with the complex problems of children with arthritis and other rheumatic diseases.
However, there are very few such specialists, and some areas of the country have none at all. In such circumstances, a team approach involving the child's pediatrician and a rheumatologist, with experience in both adult and pediatric rheumatic disease, provides optimal care for children with arthritis. Other important members of the team include physical therapists and occupational therapists.
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