However, Dr. Cron has found that treating rheumatic conditions aggressively early on and then backing off therapy generally leads to lower doses and shorter duration of corticosteroid use in diseases that frequently require their use.
“Sometimes, families need additional time to accept the concept of better outcomes when chronic inflammatory disorders are treated early and aggressively,” Dr. Cron says. “I remind guardians that without treatment, a child may not be able to participate in certain athletic activities. There are also long-term consequences to undertreated chronic inflammation.”
Dr. Cron
Dr. Cron may compromise on a partial treatment plan (e.g., for polyarticular juvenile arthritis, weekly subcutaneous methotrexate rather than a combination of weekly methotrexate and a tumor necrosis factor inhibitor). “Usually, it doesn’t take long before the family realizes how much better off the child is with additional medicine or a more aggressive approach, so they are willing to try the full regimen in the short term.”
