Dr. Lovell says the results of these studies are especially encouraging because the improvements were seen in children who were treatment-resistant.

While older biologics – TNF inhibitors – are prescribed for some types of juvenile arthritis, they are not very effective in controlling the whole body (systemic) features of sJIA. Treatment with corticosteroids helps control the systemic symptoms, but used long-term, they carry a high risk of side effects, such as inhibited growth, high blood pressure and weight gain.

In both trials, the treatments allowed for a significant tapering of corticosteroids.

Dr. Lovell says long-term studies will look for answers to better understand long-term safety issues and address other questions, such as whether some patients have disease that is more closely linked to IL-6 or IL-1. “If you don’t respond to one of these agents, what are your chances of responding to the other? That’s an unknown question. That’s something that will need to be defined once the agents are out more in clinical use,” Dr. Lovell says.

Christy I. Sandborg, MD, a professor of pediatric rheumatology at Stanford University School of Medicine in Palo Alto, Calif., co-authored an editorial accompanying the studies that remarked on the impressive effectiveness of the drugs and the speed with which they helped children. But she agrees there is still a lot to learn about these medications.

“The question is, are they targeting the same thing? A similar step in the same pathway? Or are they targeting different things? And that’s something we don’t know,” Dr. Sandborg says.

She agrees long-term safety and efficacy need to be studied, especially if doses have to be increased over time. She also stresses that the medications didn’t help 20 percent of patients in these studies. “It doesn’t work in everybody. It’s not perfect. It’s not a silver bullet. But it’s pretty close to it,” Dr. Sandborg says.

“These drugs are incredibly effective. It really is a new era. And now it’s incumbent on us – doctors and the FDA – to monitor these agents to make sure that we understand the safety profile so that we can all make the best decisions and tailor the therapies,” she says.

Dr. Sandborg says one way to do that is through the Childhood Arthritis and Rheumatology Research Alliance (CARRA) – an organization of more than 350 pediatric rheumatologists and researchers in the U.S. and Canada committed to researching juvenile arthritis. So far about 60 centers are working with the group to enroll children in a registry to track symptoms and treatments. To find out more, visit carragroup.org.