NDLI: Glucocorticoids in the management of systemic juvenile idiopathic arthritis.

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Glucocorticoids in the management of systemic juvenile idiopathic arthritis.

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Glucocorticoids in the management of systemic juvenile idiopathic arthritis.

Content Provider	World Health Organization (WHO)-Global Index Medicus
Author	Vannucci, Gaia Cantarini, Luca Giani, Teresa Marrani, Edoardo Moretti, Davide Pagnini, Ilaria Simonini, Gabriele Cimaz, Rolando
Description	Author Affiliation: Vannucci G ( Rheumatology Unit, AOU Meyer and University of Florence, V. le Pieraccini 24, 50141, Florence, Italy, gaia.vannucci@gmail.com.)
Abstract	Glucocorticoids have been the mainstay of treatment for many years in systemic-onset juvenile idiopathic arthritis (sJIA), causing important side effects and some difficulties in the management of this disease. Until the introduction of biologic agents, oral glucocorticoids were used to control fever and other systemic features for several months or even years if systemic manifestations persisted. Nowadays, clinicians have valid alternatives that have revolutionized the natural history of sJIA. Biologic agents, such as the interleukin-1 inhibitors anakinra and the more recent canakinumab, or the interleukin-6 inhibitor tocilizumab, have improved the prognosis of this debilitating disease. Glucocorticoids still have to be considered at the onset of disease when a non-steroidal anti-inflammatory drug therapy fails or when there are life-threatening complications such as severe anemia or pericarditis, or macrophage activation syndrome. Local (intra-articular) triamcinolone hexacetonide is the treatment of choice for arthritis limited to one joint or a few joints in patients without systemic activity. To date, there is still great heterogeneity in the management of sJIA patients, but in recent years there have been attempts to design algorithms and treatment protocols for glucocorticoids, disease-modifying anti-rheumatic drugs, and biologic agents. This review provides an overview of the current knowledge of glucocorticoid therapy in sJIA, comments on recently published recommendations, and gives practical support to the clinician for management of this disease.
File Format	HTM / HTML
ISSN	11745878
Issue Number	5
Volume Number	15
e-ISSN	11792019
Journal	Pediatric Drugs
Language	English
Publisher	Springer
Publisher Date	2013-10-01
Publisher Place	Switzerland
Access Restriction	One Nation One Subscription (ONOS)
Subject Keyword	Discipline Drug Therapy Discipline Pediatrics Anti-inflammatory Agents Therapeutic Use Antirheumatic Agents Arthritis, Juvenile Drug Therapy Glucocorticoids Adverse Effects Antibodies, Monoclonal Antibodies, Monoclonal, Humanized Child Humans Interleukin 1 Receptor Antagonist Protein Interleukin-1 Antagonists & Inhibitors Interleukin-6 Macrophage Activation Syndrome Etiology Prevention & Control Triamcinolone Journal Article Review
Content Type	Text
Resource Type	Article
Subject	Pharmacology (medical) Pediatrics, Perinatology and Child Health

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