liver damage may occur, though it’s much less common in kids than in adults. Many doctors recommend regular liver tests for any child taking the drug. And because methotrexate weakens the immune system, a doctor may refrain from giving live-virus vaccines to a child on the drug. Check with your doctor about other drugs that can be used to treat juvenile arthritis.
As with methotrexate, it pays to be cautious with any medicine that affects the immune system. Many DMARD drugs have a black box warning — the most serious drug warning the Food and Drug Administration issues. Children should be current on all of their immunizations before taking the drug, and they shouldn’t take the drug within three months of receiving a live-virus vaccine. To be extra safe, they should briefly stop taking the drug if they’ve been exposed to chickenpox. (Always check with a doctor before stopping any drug.)
Some biologic drugs, including Enbrel, have also been used as second-line treatments for juvenile arthritis. Enbrel has been been associated with certain infections, including tuberculosis; it has also been associated with an increased risk of lymphoma when used in children and teens and has a black box warning, according to the FDA.
In severe cases of JA, doctors might combine powerful drugs called corticosteroids with other treatments. These drugs can dramatically reduce inflammation. However, long-term use of the drugs can cause many serious side effects, including weakened bones and a vulnerability to infections. Once symptoms are under control, a doctor will slowly reduce the dose to lower the risk of complications.
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What else can I do to help my child?
First of all, treat your child normally. Their arthritis shouldn’t change your love, discipline, or expectations. Your child may need to rest during flare-ups, but he or she should stay as active as possible when symptoms fade. Regular exercise will help keep their joints strong and flexible. A physical therapist can help recommend exercises and activities that will be especially helpful.
