When is methotrexate indicated in the treatment of systemic juvenile idiopathic arthritis (JIA) with active arthritis without active systemic features?

Updated: Jul 25, 2019
  • Author: David D Sherry, MD; Chief Editor: Lawrence K Jung, MD  more...
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Answer

After 3 months of methotrexate therapy, the next step in escalation is to anakinra or a TNF-α inhibitor, although etanercept is less effective in systemic arthritis than in other forms of JIA. [41] Patients who show inadequate response to TNF-α inhibitor treatment can be started on abatacept.


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