Juvenile Idiopathic Arthritis — Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis and Systemic JIA
Key Points
Key Points
- Consistent with the ACR’s 2019 JIA guidelines, these recommendations are for persons already diagnosed with juvenile idiopathic arthritis (JIA).
- Aside from poor prognostic features specified within the recommendations themselves (e.g., specific joints for oligoarthritis, macrophage activation syndrome [MAS]), extra-articular coexisting conditions that would influence disease management, such as uveitis, psoriasis or inflammatory bowel disease, are not addressed within these guidelines.
- Recommendations are intended to be used by all clinicians caring for persons with JIA and assume that patients do not have contraindications to the recommended pharmacologic treatments.
- Longer-term glucocorticoid therapy in childhood is not appropriate because of its effects on bone health and growth. Thus, wherever glucocorticoids are suggested, recommended treatment should be limited to the lowest effective dose for the shortest duration possible.
- Shared decision-making with families and patients is important when considering treatment options.
Treatment
...reatment...
...of InterventionsHaving trouble viewing table? Exp...
...ligoarthritis...
...ial of consistent NSAIDs is condition...
...ticular glucocorticoids (IAGCs) are...
...ne hexacetonide (THA) is strongly recommended as...
...glucocorticoids are conditionally recom...
...( Low , Strong )608...
...SZ, HCQ) ( Very low , Strong )...
...) ( Low , Conditional )608...
...F, SSZ, HCQ) ( Very low , Conditional )608
...s are strongly recommended if there...
...no preferred biologic DMARD. ( Very low , )608...
...of risk factors for poor outcome (e.g.,...
...of validated disease activity mea...
...Arthritis
...istent NSAIDs is conditionally recommended as par...
...itionally recommended as part of init...
...is no preferred agent. ( Very low , )608...
...icoids are conditionally recommended aga...
...tional synthetic DMARDs are strongly recomme...
...te is conditionally recommended as a pr...
...DMARDs are conditionally recommended for inad...
...referred biologic agent. ( Very low...
...deration of poor prognostic features (e...
...ic JIA Inactive Disea...
...continuing glucocorticoids is strongly recommended...
...d discontinuing biologic DMARDs is condi...
...temic JIA Without MAS
...nditionally recommended as initial m...
...al glucocorticoids are conditionally reco...
...synthetic DMARDs are strongly recomme...
...c DMARDs (interleukin [IL-1 and IL-6 inhibitors])...
...is no preferred agent. ( Very low...
...and IL-6 inhibitors are strongly r...
...iologic DMARDS or conventional synthetic DMARDS...
...preferred agent. ( Very low , )608...
...c JIA With MAS...
...6 inhibitors are conditionally recomme...
...ocorticoids are conditionally recommended as p...
...ferred agent. ( Very low , )608...
...DMARDs or conventional synthetic DMARDs are stro...
...no preferred agent. ( Very low , )608...
...eatment for Oligoarthritis...
.... Treatment for TMJ Arthritis...
...3. Treatment for Systemic JIA...