Ref Number = ASPR0012
Drugs For Pediatric Rheumatology Cases
Zahrah Hikmah, Anang Endaryanto
aDepartment of Child Health Medical Faculty of Airlangga University, Surabaya, Indonesia
bDepartment of Child Health, Medical Faculty of Universitas Airlangga, Surabaya, Indonesia 
*E-mail: drzahrahhikmah@gmail.com
The rheumatic diseases are chronic multisystem disorders that represent clinical manifestations of acute and chronic inflammation in the connective tissues of the muscu?loskeletal system, blood vessels, and skin. Childhood rheumatic diseases are major and often unappreciated causes of significant chronic illness. Arthritis and other rheumatic symptoms affect an estimated 0.1% to 0.5% of the population under 18 years of age. Population studies indicate that 62% of those children have disability that inhibits their activities of daily living. 
Pediatric Rheumatology includes a variety of inflammatory disorders that involve joints and connective tissue in children. Adolescent idiopathic arthritis is probably the most well-recognized rheumatic disease in childhood. The scope of the disease is including conditions such as juvenile idiopathic arthritis (JIA), acute rheumatic fever, post-streptococcal reactive arthritis, Kawasaki Lyme Disease, chronic systemic diseases and conditions including Systemic Lupus Erythematosus (SLE), Juvenile Dermatomyositis (JDM), and vasculitides. The most common rheumatic disease affecting children is chronic arthritis (JIA).  The impact of this disease can be significant. 
Most of childhood rheumatic disease cannot be cured completely. The goal of the treatment is to limit pain and inflammation, induce remission, slow the progression of the disease, prevent further complications, and improve the quality of life of children with rheumatic diseases. Each treatment plan designed by a doctor should be specifically tailored to the patient's type of rheumatic disease, as well as the severity of the disease, and patient?s condition.
Non-steroidal anti-inflammatory drugs (NSAIDs), glucocorticoids, disease-modifying antirheumatic drugs (DMARDs) are used in the treatment of rheumatology diseases. NSAIDs and glucocorticoids are effective in reducing pain and inhibiting inflammation, while DMARDs have the capacity to reduce tissue and organ damage caused by the inflammatory response. Recently, treatments for rheumatology diseases have been revolutionized with the discovery that TNF is very important in the development of the disease. Biologic agents (such as infliximab, adalimumab, etanercept, golimumab, and certolizumab pepol) have markedly improved the outcome of the management of autoimmune inflammatory diseases. However, a considerable proportion of patients do not respond to anti-TNF treatment. Biologic agents are expensive, and are associated with some adverse effects. 
It is important to understand the absolute risk of all adverse event from using pediatric rheumatic drug in all patients. Adverse event that are cause by any rheumatology drug may be difficult to determine. The type and level of risk related not only to the mechanism of action of individual drugs but also dosage and duration, using  drugs or other substances together, age, lifestyle, and heredity. Side effects of drugs used to treat rheumatic diseases can generally be divided into metabolism, toxic, neoplastic, and infectious. Metabolic side effects include conditions such as weight gain, fatigue, and decreased bone density. Toxic side effects will cause tissue and organs injury (eg skin, liver, kidney).
Children with rheumatic disease must undergo regular laboratory tests for monitor the side effects of rheumatic drugs. Careful monitoring of the disease and programmed programmed using adjusted appropriate medication will control the condition. It is important for most patient for being able to live with a normal life span. 
Keywords: Rheumalogy disease, child, drugs
Disclaimer: The Views and opinions expressed in the articles are of the authors and not of the journal.
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