ABSTRACT
The spectrum of rheumatic disorders in childhood is varied and includes several disorders sharing the same broad aetiopathogenesis (i.e. that of a complex genetic trait interacting with an as yet undefined environmental trigger). The phenotypical features of each disease are determined by an organ-specific autoimmune process. Until the recent advent of biological therapies, the pharmacological management of rheumatic disorder in childhood involved the use of agents with a broad antiinflammatory or immunosuppressant mode of action. The improved outcome in many rheumatic diseases has been associated with earlier and more aggressive use of such immunosuppressants which may be considered as disease modifying antirheumatic drugs (DMARDs). Targeted biological therapy is now available to the paediatric rheumatologist in the form of anti-tumour necrosis factor alpha (TNF-a) treatment, with the realistic expectation that other biological agents will soon complete the transition from experimental to licensed therapy.
