Question

14 yr old child with Naive Rheumatoid Arthritis patient as shown in image . What should be the correct treatment of given condition:

• A. DMARD with short course of Steroids
• B. Only NSAID’S
• C. DMARD after initial 3 months of NSAID’S
• D. Monotherapy with TNF drugs

Answer 1

The Correct Option is A

In the case of treating Naive Rheumatoid Arthritis (RA), especially in pediatrics (Juvenile Idiopathic Arthritis - JIA type), it is crucial to understand the treatment principles aimed at reducing inflammation, preventing joint damage, and maintaining function. The correct treatment involves:

• Using DMARDs (Disease-Modifying Anti-Rheumatic Drugs): These drugs are fundamental in managing RA as they help in slowing down the autoimmune process and preventing joint damage.
• A short course of Steroids: Corticosteroids can provide a rapid anti-inflammatory effect and symptom relief. They are generally used as bridge therapy until DMARDs take effect.

The effectiveness of this combination therapy in moderate to severe cases helps bring the disease under control more quickly than using NSAIDs or DMARDs alone, as they act on different pathways in the inflammatory process.

Final Recommendation: DMARD with short course of Steroids.