Juvenile Idiopathic Arthritis: Features of DMARD and SAARD Drugs

Topic Overview

Medicine will likely be an important part of your child's treatment. Treatment varies depending on the needs of each child, but certain medicines are often tried first. These are known interchangeably as disease-modifying antirheumatic drugs (DMARDs) and as slow-acting antirheumatic drugs (SAARDs).

DMARDs/SAARDs include azathioprine, cyclosporine, etanercept, methotrexate, and sulfasalazine.

DMARDs/SAARDs have a lot in common.

• They are slow to take effect. It may take 8 to 24 weeks for the drug to show a benefit.
• They have a small risk of serious side effects (on blood cells, eyes, kidney, or liver). Side effects can be detected with close monitoring and are reversible if the drug is stopped.
• They have a moderate risk of side effects that may be uncomfortable but are not serious (nausea, skin rash, mouth sores, diarrhea, hair thinning).
• While these medicines offer effective treatment for many children, they are not a reasonable treatment option for others. Side effects or ineffectiveness, or both, are common reasons that children are withdrawn from DMARD/SAARD treatment.
• NSAIDs are often used together with one of these medicines.

Although these medicines are often called "disease-modifying," it has been hard to prove that they truly prevent long-term joint damage. But they often relieve pain and swelling.