Diagnosing arthritis in children dates back to the mid-1800s. Today, rheumatologists and other kinds of doctors treat several types of juvenile idiopathic arthritis (JIA), each with its own symptoms. Two forms of the disease include polyarticular JIA, or PJIA, and systemic JIA, or SJIA.
The key to PJIA is the polyarticular. Let’s break it down further: poly means many. So think of polyarticular as many joints (5 or more, according to its medical definition). Juvenile simply describes the age group affected by the disease. While arthritis means inflammation of one or more joints, idiopathic refers to the cause of the disease: it’s unknown.
The immune system is complex. It has many different kinds of cells that protect the body by fighting harmful things like bacteria, fungi, and viruses. When the immune system is not working correctly, it can lead to the signs and symptoms of PJIA, such as inflammation, pain, and stiffness.
PJIA has things in common with other forms of JIA—joint pain, for example. But PJIA is unique because of that “5 or more joints” feature. Other forms of JIA typically affect a limited number of joints. In addition, a child with PJIA may find it difficult to chew food, because PJIA can affect not just smaller joints like those in fingers or toes, but also larger joints such as those in the jaw or neck. And unlike some forms of JIA, PJIA often affects both sides of the body, not just one side.
Also, PJIA does not include body-wide symptoms such as rashes or high fevers common to another form of JIA called systemic JIA (SJIA). PJIA is also more common than SJIA: about 1 in 4 children with JIA have PJIA, while only 1 in 10 with JIA have SJIA. Girls tend to get PJIA more than boys do, but both may develop SJIA at about the same rate.
Please see Important Safety and Side Effect Information. For additional Important Safety Information, please see full Prescribing Information, including BOXED WARNING and Medication Guide.
ACTEMRA is a prescription medicine called an interleukin-6 (IL-6) receptor antagonist.
ACTEMRA is used:
It is not known if ACTEMRA is safe and effective in children with PJIA or SJIA under 2 years of age or in children with conditions other than PJIA or SJIA.
ACTEMRA changes the way your immune system works. This can make you more likely to get infections or make any current infection worse. Some people have serious infections while taking ACTEMRA, including tuberculosis (TB), and infections caused by bacteria, fungi, or viruses that can spread throughout the body. Some people have died from these infections. Your healthcare provider should assess you for TB before starting and during treatment with ACTEMRA (except if you have COVID-19).
Before starting ACTEMRA, tell your healthcare provider if you have:
If you have COVID-19, your healthcare provider should monitor you for signs and symptoms of new infections during and after treatment with ACTEMRA.
Do not take ACTEMRA if you are allergic to tocilizumab, or any of the ingredients in ACTEMRA.
Be sure to talk to your healthcare provider if you see any signs of these serious side effects:
If you have diverticulitis (inflammation in parts of the large intestine), talk to your healthcare provider before taking ACTEMRA. Some people taking ACTEMRA may develop a hole in the wall of their stomach or intestines (also known as a perforation). This happens most often in people who also take nonsteroidal anti-inflammatory drugs (NSAIDs), corticosteroids, or methotrexate.
Tell your healthcare provider right away if you see any of these side effects: fever, stomach-area pain that does not go away, or if you see a change in your bowel habits.
Some people have experienced serious life-threatening liver problems, which required liver transplant or led to death. Your healthcare provider may tell you to stop taking ACTEMRA if you develop new or worsening liver problems during treatment with ACTEMRA. Tell your healthcare provider right away if you have any of the following symptoms:
Your healthcare provider should do blood tests before you start receiving ACTEMRA. If you have rheumatoid arthritis (RA) or giant cell arteritis (GCA), or systemic sclerosis-interstitial lung disease (SSc-ILD) your healthcare provider should do blood tests 4 to 8 weeks after you start receiving ACTEMRA for the first 6 months and then every 3 months after that. If you have polyarticular juvenile idiopathic arthritis (PJIA) you will have blood tests done every 4 to 8 weeks during treatment. If you have systemic juvenile idiopathic arthritis (SJIA) you will have blood tests done every 2 to 4 weeks during treatment. These blood tests are to check for the following side effects of ACTEMRA:
Your healthcare provider will determine how often you will have follow-up blood tests. Make sure you get all your follow-up blood tests done as ordered by your healthcare provider.
You should not receive ACTEMRA if your neutrophil and platelet counts are too low or your liver function test levels are too high. Changes in blood test results may cause your healthcare provider to stop your ACTEMRA treatment for a time or change your dose.
ACTEMRA may increase your risk of certain cancers by changing the way your immune system works.
If you have or are a carrier of the hepatitis B virus (a virus that affects the liver), the virus may become active while you use ACTEMRA. Your healthcare provider may do blood tests before you start treatment with ACTEMRA and while you are using ACTEMRA. Tell your healthcare provider if you have any signs of these symptoms:
Serious allergic reactions, including death, can happen with ACTEMRA. These reactions can happen with any infusion or injection of ACTEMRA, even if they did not occur with an earlier infusion or injection. Tell your healthcare provider before your next dose if you had hives, rash or flushing after your injection.
Contact 911 immediately, as well as your healthcare provider, if you experience any of these reactions:
While rare, Multiple Sclerosis has been diagnosed in people who take ACTEMRA. It is not known what effect ACTEMRA may have on some nervous system disorders.
ACTEMRA may not be right for you. Before receiving ACTEMRA, tell your healthcare provider if you:
Tell your healthcare provider if you are planning to become pregnant, are pregnant, plan to breast-feed, or are breast-feeding. You and your healthcare provider should decide if you will take ACTEMRA or breast-feed. You should not do both. If you are pregnant and taking ACTEMRA, join the pregnancy registry. The purpose of this registry is to check the health of the pregnant mother and her baby. To learn more, call 1-877-311-8972 or talk to your healthcare provider to register.
Tell your healthcare provider if you have any side effects. You may report side effects to the FDA at 1-800-FDA-1088. You may also report side effects to Genentech at 1-888-835-2555.
Please see full Prescribing Information and the Medication Guide, including Serious Side Effects, for more Important Safety Information.
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