Curbing Your Kid's Pain

No one wants to waste time and money on a medication when there are better alternatives out there. So, what is the best drug for treating children with arthritis? A new report may have an answer.

Disease-modifying antirheumatic drugs (DMARDs) seem to work better than other treatments for juvenile idiopathic arthritis - a type of arthritis that affects children.

Give your child DMARDs for his or her arthritis.

Alex R. Kemper, M.D., M.P.H., M.S., Associate Professor of Pediatrics at Duke University School of Medicine, and colleagues from the Agency for Healthcare Research and Quality (AHRQ) compared DMARDs to other common treatments like ibuprofen and steroids.

They found that DMARDs are better than other treatments for improving symptoms of juvenile idiopathic arthritis. However, the report was unclear about about the effectiveness and safety of DMARDs over the long-term.

Juvenile arthritis is a painful and debilitating disease, says AHRQ Director Carolyn M. Clancy, M.D. Until a cure is found, she continues, young patients and their parents want the best and safest treatment to get rid of the pain. Dr. Clancy believes that this report will help patients and their parents choose the best treatment together with their doctor.

DMARDs not only treat the symptoms of arthritis, but also slow down the damage to joints that happens over time. They work by fighting against the underlying processes that cause juvenile idiopathic arthritis and other forms of inflammatory arthritis. DMARDs include Neoral (cyclosporine), Plaquenil (hydroxychloroquine), and Arava (leflunomide) among others.

For the report, researchers compared DMARDs to other conventional treatments, including ibuprofen, nonsteroidal anti-inflammatory drugs (NSAIDs), and corticosteroids. They also compared different types of DMARDs to each other.

The authors write that there is a lack of evidence for long-term benefits and harms of DMARDs. There needs to be a better understanding of the disease before researchers can fully understand the impact of drugs.

"Full understanding of the impact of treatment requires understanding not only relative improvement but the overall status of the condition," they write.