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

rs 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

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

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