Bardare M, Corona F, Rognoni M G
I Clinica Pediatrica, Università degli Studi di Milano.
Minerva Pediatr. 1992 May;44(5):211-21.
The correct drug treatment of JRA must consider the course and the subtype of the disease. Nonsteroidal antiinflammatory drugs are the first choice treatment, especially the recent ones which are more active and less toxic. The slow-acting antirheumatic drugs are the second choice treatment and must be employed in the chronically active stages of the disease; good results have been obtained with sulphasalazine and methotrexate both on clinical features and on blood biochemistry with relatively scarce side effects. Thymic hormones, cyclosporin A and intravenous immunoglobulins, though not yet widely experienced, can represent a worthwhile alternative to standard treatment in carefully selected cases. Steroids must be used only in special cases (particularly aggressive systemic JRA, carditis, severe anemia and those patients who fail to respond to usual treatments) and must be withdrawn as soon as possible to avoid adverse effects and steroid-addiction. Intraarticular long-acting steroids are the first choice treatment for rheumatoid monoarthritis.
幼年类风湿性关节炎（JRA）的正确药物治疗必须考虑疾病的病程和亚型。非甾体抗炎药是首选治疗药物，尤其是那些近期使用的、活性更强且毒性更小的药物。慢作用抗风湿药是次选治疗药物，必须在疾病的慢性活动期使用；柳氮磺胺吡啶和甲氨蝶呤在临床特征和血液生化方面均取得了良好效果，且副作用相对较少。胸腺激素、环孢素A和静脉注射免疫球蛋白，尽管尚未广泛应用，但在精心挑选的病例中，可作为标准治疗的一种有价值的替代方案。类固醇仅在特殊情况下使用（特别是侵袭性全身型JRA、心肌炎、严重贫血以及那些对常规治疗无反应的患者），并且必须尽快停用，以避免不良反应和类固醇成瘾。关节内长效类固醇是类风湿性单关节炎的首选治疗药物。
