Examples

Taken by mouth (pill form, oral)

Injected

Eyedrops

How It Works

Corticosteroids are similar to natural hormone substances produced by the body that help to reduce inflammation.

Why It Is Used

Corticosteroids are often used to treat juvenile idiopathic arthritis. Corticosteroids that are taken by mouth or injected are most often used to control the initial stages of systemic juvenile idiopathic arthritis (JIA). Corticosteroids may also be used in children who have oligoarticular or polyarticular disease with severe morning stiffness or night pain.

A short "burst" therapy (initially high doses of oral corticosteroids that are tapered off) may be useful when inflammation around the heart (pericarditis) or fever is present in children with systemic JIA.

Corticosteroids may also be used as "bridge" therapy when starting a stronger second-line medicine, such as methotrexate, to control symptoms while the new medicine takes effect. After a period of time, the corticosteroid is slowly withdrawn to see whether the other medicine is effective.

Injections of corticosteroids may be used to treat specific joints when conservative therapy has controlled symptoms well except in those specific joints.

Corticosteroid eyedrops are used in children who develop inflammatory eye disease.

How Well It Works

Corticosteroids can provide rapid, dramatic improvement in some people with JIA.¹

• Oral corticosteroids are often useful:
  • For children with systemic JIA who have fever and inflammation of the protective sac around the heart (pericarditis).
  • For controlling night pain or morning stiffness in JIA.
  • For controlling a flare-up of symptoms in polyarticular JIA.
  • While waiting for another drug such as methotrexate or etanercept to take effect. Methotrexate and etanercept are disease-modifying antirheumatic drugs (DMARDs).
• Injected corticosteroids usually help when they are injected into the painful joints of children with limited arthritis, especially in children who have not responded to nonsteroidal anti-inflammatory drugs (NSAIDs) or who can't tolerate NSAIDs.
• Intravenous corticosteroids can help manage joint disease, but they are usually used only in children who have life-threatening complications such as pericarditis.
• Corticosteroid eyedrops usually act quickly to control a flare-up of eye inflammation.

Side Effects

Side effects of high or long-term corticosteroid doses in children include:

• Growth suppression.
• Bone thinning (osteoporosis).
• Easy bruising.
• Moon-face appearance with fluid retention and weight gain (cushingoid appearance, related to Cushing's syndrome).
• Mood swings.