Navigation Links
New clinical practice guidelines developed for juvenile idiopathic arthritis
Date:3/30/2011

ATLANTA The American College of Rheumatology has developed new guidelines for starting and monitoring treatments for children with juvenile idiopathic arthritis. These are the first JIA guidelines endorsed by the ACR, with the goal of broad acceptance within the rheumatology community.

Created as a guide for health care providers, the guidelines focus on the initiation and safety monitoring of multiple medications used in the treatment of JIA, including:

  • Non-steroidal anti-inflammatory drugs (e.g. ibuprofen, naproxen, and many others)
  • Intraarticular glucocorticoid injections (i.e. steroid joint injections)
  • Non-biologic disease-modifying antirheumatic drugs: (e.g. methotrexate)
  • Biologic disease-modifying antirheumatic drugs: (e.g. abatacept, anakinra and TNF-α inhibitors such as etanercept, adalimumab, infliximab)
  • Systemic glucocorticoids: (e.g. prednisone)

It is estimated that one child in every 1,000 will develop a rheumatic disease. Nearly 300,000 American children suffer from juvenile idiopathic arthritis, which begins before patients reach the age of 16 and may involve chronic inflammation of one or many joints. JIA often persists into adulthood and can cause long-term co-existing conditions and disability. However, recent treatment advances have greatly improved short-and medium-term outcomes for these patients.

Recommendations Based on Sound Research

The research team led by Timothy Beukelman, MD, MSCE American College of Rheumatology member and assistant professor of pediatrics in the Division of Pediatric Rheumatology at the University of Alabama at Birmingham developed the guidelines using established processes from the RAND/UCLA Appropriateness Method. The method defines appropriate patient care by combining the best available scientific evidence with the collective judgment of experts.

The research team which included clinicians, researchers and a patient advocate with experience and expertise in JIA reviewed over 200 studies related to JIA treatment and evaluated more than 1,500 clinical scenarios that captured a broad range of medical decisions that are made in the care of JIA patients. The team explicitly considered when the benefits of using certain drugs outweigh any risks. Because JIA can affect each person differently, patients with similar disease characteristics were separated into five different JIA treatment groups to help streamline the recommendations.

"These recommendations were developed by two distinct panels of international pediatric rheumatology experts using a rigorous methodology," says Dr. Beukelman. "Our goal was to provide evidence and consensus-based guidance that reflects the current state of the field and is useful to clinicians of all levels of experience with the treatment of JIA. The recommendations are important because the treatment of JIA has undergone major changes over the last decade with the introduction of biologic therapeutic agents."

Recommendation Highlights

The recommendations for initiation of multiple medications for JIA were based on several clinical factors: JIA treatment group; current disease activity level; disease prognosis; and current treatment.

A brief summary of some of the most notable recommendations includes:

  • Beginning treatment with TNF-α inhibitors in children with a history of arthritis in four or fewer joints and significant active arthritis despite treatment with methotrexate

  • Beginning treatment with TNF-α inhibitors in children with a history of arthritis in five or more joints and any active arthritis following an adequate trial of methotrexate

  • Beginning treatment with anakinra in children with systemic arthritis and active fever whose treatment requires a second medication in addition to systemic glucocorticoids

"We expect that knowledge of the safest and most effective treatments for JIA will continue to advance, and we suggest regularly updating these recommendations using newly published evidence," says Dr. Beukelman. "Ongoing research, both in the clinic and the laboratory, is critical to understanding how to best treat JIA and will help to continue to improve the quality of life for children with the disease."

Patients should talk to their rheumatologists to determine their best course of treatment.


'/>"/>

Contact: Dawn Peters
healthnews@wiley.com
781-388-8408
Wiley-Blackwell
Source:Eurekalert

Related medicine news :

1. Bryan Roth honored for excellence in clinical pharmacology
2. IOM recommends standards to achieve reliable clinical practice guidelines
3. Clinical trial seeks to determine whether platelet-rich plasma can ease the pain of osteoarthritis
4. Jefferson clinical trial: Can a cholesterol drug prevent colon cancer?
5. Clinical trial for dry mouth funded by international oral care award
6. Revitalizing Cancer Clinical Trials -- March 21 symposium
7. Novel clinical trial aims to reduce recurrence of aggressive breast cancer
8. Clinical observation leads to lung cancer discovery
9. Study reveals security weaknesses in file-sharing methods used in clinical trials
10. UT Southwestern launches clinical trial for treatment of breast cancer using CyberKnife
11. Elsevier/MEDai enhances real-time clinical surveillance system for hospitals
Post Your Comments:
*Name:
*Comment:
*Email:
(Date:5/6/2016)... ... May 06, 2016 , ... In honor of ... and corporate training, and the National Military Family Association, a nonprofit that works ... the second full-tuition scholarship recipient of 2016. , “Being awarded this scholarship ...
(Date:5/5/2016)... ... , ... TransWipe Volume 3 is a set of 30 professional transition animations ... between two video clips to instantly add a unique transition to any Final Cut ... and orientation options. TransWipe Volume 3 is a Final Cut Pro X exclusive plugin. ...
(Date:5/5/2016)... ... May 05, 2016 , ... The U.S. Food ... requiring e-cigarette manufacturers to submit their products through an arduous federal approval process. ... products that entered the market since February 15, 2007. That would essentially ban ...
(Date:5/5/2016)... SAN FRANCISCO (PRWEB) , ... May 05, 2016 ... ... in the Unites States to promise successful results with IVF and with egg ... Designed to deliver the most patient-centric and highest quality fertility care, Spring Fertility ...
(Date:5/5/2016)... Bremerton, WA (PRWEB) , ... May 05, 2016 , ... ... program serving the families of Bremerton, Port Orchard and communities west of Seattle. The ... Lowery, a 12 year local girl who died suddenly due to complications from the ...
Breaking Medicine News(10 mins):
(Date:5/3/2016)... 4, 2016 Global Insulin ... profiling 09 key companies and supported with 272 ... in-depth study on the current state of the ... the industry including definitions, classifications, applications and industry ... provided for the international market including development history, ...
(Date:5/3/2016)... from Sino-German High-Tech Fund to further expand product development, strengthen its disease modeling capabilities and increase market presence. ... ... ... ... Sino-German High-Tech ...
(Date:5/3/2016)... 2016   BIOTRONIK , a leader in ... and Drug Administration (FDA) approval of Iperia ProMRI ... failure patients with access to diagnostic magnetic resonance ... monitoring with daily automatic transmission and closed loop ... response to physiological demands. ...
Breaking Medicine Technology: