Parent and Caregiver Resources

Make treatment easier for your child

Caring for a child with arthritis is not always easy. But there are resources available to help. In addition to the information listed below, the child's doctor or staff can be a useful asset when you need it most. It's always a good idea to partner closely with them during your child's treatment. 

Talking about your child’s condition

With a disease as challenging as SJIA, it's essential to keep the lines of communication open. Explaining to others what your child is going through can go a long way in ensuring that he or she is taken care of appropriately. Equally as important is talking to your child about the disease. Below are tips to keep in mind when speaking to various audiences including your child, your child’s school, and even your family. 

Speaking with your child about the disease

While it may be challenging to discuss health situations with your child, it is important to talk with your child about his or her disease. Below are 5 tips on how to communicate with your child.

1. Set a positive tone: How you handle and discuss delicate information will help set the tone for how your child feels and talks about his or her condition.

2. Be up front: You may want to protect your child from difficult situations, but withholding information may actually make him or her feel there is something to be embarrassed about or feared.

3. Keep communication open: Talking and listening openly helps ensure that if your child starts feeling worse or gets new symptoms, you can consult your child's doctor as soon as possible.

4. Be supportive: Children may feel ashamed of "being different" from their friends. Having a supportive family can make children feel more confident and empowered about facing the disease.

5. Consider counseling: Talking to someone outside of the family, like a counselor or psychologist, can provide additional insights while helping your child work through his or her feelings about the disease.

Speaking with your child's school

With the amount of time children spend in school, it may be necessary to talk about your child’s condition with teachers, school counselors, and nurses. When they’re aware of your child’s needs, they can help make your child’s life easier when you’re not around. Certain changes may need to be made so your child can get the most out of the school day. 

Your child may:

  • Be absent from school because of flare-ups of pain, or to travel for ACTEMRA infusions
  • Need extra time for homework and tests
  • Have side effects from treatments for flare-ups during the school day and may need medical assistance
  • Need extra time to get to and from class, and may need to leave one class early to make the next
  • Be tired or distracted during the day, which can affect classroom concentration

Speaking with your family about your child’s condition

Raising a child with SJIA can impact a lot of people in your child’s life, like family, friends, and caregivers. That larger support network can make the child feel comfortable and secure knowing there are a lot of people he or she can count on. 

Family members should know:

  • If you are caring for more than one child, it may be difficult to give everyone the attention he or she needs. Children may feel neglected if one of their siblings is receiving a lot of attention, good or bad
  • Managing SJIA can be difficult, and every family situation is different. Your child’s doctor can direct you to valuable resources that can help the whole family manage the disease, but don’t be afraid to ask questions about your family’s unique circumstances

Tips for helping your kids

There are many things to consider when raising a child with systemic juvenile idiopathic arthritis (SJIA). Your child's doctor and healthcare team can answer your questions. Here are some tips to consider while your child is being treated for SJIA. 

Healthy diet: It's important that your child continues to eat a healthy diet no matter what treatment for SJIA he or she is on. 

Exercise: Encourage your child to exercise and participate in gym class and school sports as much as possible based on guidelines set by your child's doctor. Walking, riding a bike, and swimming are considered good physical activities for children with forms of arthritis. Remember to always talk to your child's doctor about exercises that are safe and beneficial for your child before starting a new routine. 

Physical and occupational therapy: Physical and occupational therapy can make it easier for your child to move swollen joints and maintain a good range of motion. Always talk to your child's doctor about therapy that is safe and beneficial for your child. 

Joint stiffness: This is common after waking up in the morning or from a nap. Taking a warm shower or bath, wearing warmer clothing, or using a hot compress can help relieve stiffness. Some children do better with a cold compress, so experiment with different treatments to see which works best. 

Medications: Monitor your child's medications in addition to ACTEMRA and make sure that all are being taken at the right times and in the right amounts as prescribed. Keep a list of your child's current medications with you for doctor visits, or if you need to go to the hospital for any reason. 

Routines: Normal routines and habits should be maintained as much as possible to help keep the physical and emotional effects of your child's condition to a minimum. 

Rest: Ensure your child gets plenty of rest to keep from getting overtired. 

School: Stress the importance of going to school, even when your child feels morning stiffness or pain.

Communication with doctors: Discuss your concerns with your child's doctor and other healthcare partners. They are there to answer your questions in addition to treating your child. 

Activities: When your child isn't feeling well, get creative with activities. Fun activities like drawing, writing, and painting can be less stressful on the joints and also provide ways for your child to express how he or she feels. 

Friends: You can also create opportunities for your child to hang out with friends if he or she isn't feeling well. Throw a sleepover or host a movie night, so your child's friends can come over. Staying in touch with friends is an important way to show your child that the illness doesn’t have to keep him or her from having a social life. 

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More resources on the Web

Learn more about arthritis care and support on the Internet. Some external sites to visit are included below.


Also, social media may be a good resource for finding additional information, support groups, forums, and a sense of community.


This website is a nonprofit information source for children's health. The site includes a section on juvenile idiopathic arthritis.


American College of Rheumatology is a great source of research and patient education on rheumatic diseases. Read patient-focused articles on diseases and conditions, types of medications, and other related topics.


Arthritis Care
Arthritis Care is the largest charity in the UK dedicated to arthritis. The organization's website offers a great deal of information on the disease, including an in-depth section geared for teenagers.


Arthritis Connect
A social network for people living with arthritis, Arthritis Connect enables members to start conversations, meet others, share treatments, and much more.


Arthritis Foundation®
This nonprofit organization's website offers information on arthritis and related conditions, including an entire section dedicated to juvenile arthritis. You'll find support groups, a pain management center, healthy living articles, and more.


These websites are not under the control of or maintained by Genentech. Including them here does not constitute an endorsement by Genentech of those other websites, the content displayed therein, or the persons or entities associated therewith. 


Before reading more, please see the Important Side Effect Information for ACTEMRA

This information does not take the place of talking with your healthcare provider about your medical condition or your treatment.

Important Side Effect Information

After reading about ACTEMRA, please talk to your healthcare provider if you have any questions.


  • Available by medical prescription only
  • For adults with moderately to severely active rheumatoid arthritis (RA) who have used one or more disease modifying antirheumatic drugs (DMARDs), such as methotrexate, that did not provide enough relief
  • For adults with giant cell arteritis (GCA)
  • For people with active PJIA ages 2 and above
  • For people with active SJIA ages 2 and above

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 can cause serious side effects

Serious infections

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 died from these infections.

Before taking ACTEMRA, tell your healthcare provider if you have:

  • An infection, think you may have an infection, are being treated for an infection, or get a lot of infections that return. Infection signs, with or without a fever, include:
    • Sweating or chills
    • Shortness of breath
    • Warm, red or painful skin or sores on your body
    • Feel very tired
    • Muscle aches
    • Blood in phlegm
    • Diarrhea or stomach pain
    • Cough
    • Weight loss
    • Burning when you urinate or urinating more often than normal
  • Any of the following conditions that may give you a higher chance of getting infections. These include: diabetes, HIV, or a weak immune system
  • Tuberculosis (TB) or have been in close contact with someone who has TB. Your healthcare provider should test you for TB before starting ACTEMRA and during treatment with ACTEMRA
  • Lived in or currently live in parts of the United States known for fungal infections. These parts include the Ohio and Mississippi River Valleys and the Southwest
  • Hepatitis B or have had hepatitis B

Be sure to contact your healthcare provider or nurse if you see any signs of these side effects.

Stomach tears

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
  • Change in your bowel habits

Changes in blood test results

Your healthcare provider should do blood tests before you start receiving ACTEMRA. If you have rheumatoid arthritis (RA) or giant cell arteritis (GCA) your healthcare provider should do blood tests 4 to 8 weeks after you start receiving ACTEMRA 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:

Low neutrophil count: neutrophils are white blood cells that help the body fight infection
Low platelet count: platelets are blood cells that help with clotting, which stops bleeding
Increase in liver function test levels
Increase in blood cholesterol levels

You should not receive ACTEMRA if your neutrophil and platelet counts are too low or your liver function test levels are too high. These may cause your healthcare provider to stop your ACTEMRA treatment for a time or change your dose. Your cholesterol levels should be checked 4 to 8 weeks after the start of your treatment, and then every 6 months after that.

Increased risk of cancer

ACTEMRA may increase your risk of certain cancers by changing the way your immune system works.

Hepatitis B infection

If you have hepatitis B, a virus that affects the liver, or are a carrier of the virus, ACTEMRA can cause the virus to become active. Your healthcare provider should test you for hepatitis B before starting treatment. Tell your healthcare provider right away if you see any signs of these symptoms:

  • Feeling very tired
  • Vomiting
  • Chills
  • Dark urine
  • Skin or eyes look yellow
  • Clay-colored bowel movements
  • Stomach discomfort
  • Skin rash
  • Little or no appetite
  • Fevers
  • Muscle aches

Serious allergic reactions

Serious allergic reactions, including death, can happen with ACTEMRA infusions or injections, even if they did not occur with an earlier infusion or injection. If you had hives, a rash, or experienced flushing after injecting, you should tell your healthcare provider or nurse before your next injection.

Contact 911 immediately, as well as your healthcare provider or nurse, if you experience any of these reactions:

  • Shortness of breath or trouble breathing
  • Swelling of lips, tongue, or face
  • Chest pain
  • Feeling dizzy or faint
  • Moderate or severe abdominal pain or vomiting

Nervous system problems

While rare, multiple sclerosis has been diagnosed in some people taking ACTEMRA.

Most common side effects

Tell your healthcare provider if you have these or any other side effect that bothers you or does not go away:

Upper respiratory tract infections (like common cold and sinus infections)


Increased blood pressure (also called hypertension)

Injection site reactions

ACTEMRA & pregnancy

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.

Reporting side effects

Tell your healthcare provider right away if you are experiencing any side effects. You may report side effects to the FDA at 1-800-FDA-1088 or You may also call Genentech at 1-888-835-2555.

For more Important Safety Information, please see full Prescribing Information and Medication Guide, including Serious Side Effects.