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2021 American Collegeof RheumatologyGuideline for theTreatment of JuvenileIdiopathic Arthritis Karen OnelDaniel B. HortonDaniel J. Lovell2022 год

2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and Systemic Juvenile Idiopathic Arthritis
review

Полный текстСтраница публикацииПубликация в OpenAlex
Аннотация: To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided.We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.Similar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional.This clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision-making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision-making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver.
Год издания: 2022
Авторы: Karen Onel, Daniel B. Horton, Daniel J. Lovell, Susan Shenoi, Carlos A. Cuello‐García, Sheila T. Angeles‐Han, Mara L. Becker, Randy Q. Cron, Brian M. Feldman, Polly J. Ferguson, Harry L. Gewanter, Jaime Guzmán, Yukiko Kimura, Tzielan Lee, Katherine Murphy, Peter A. Nigrović, Michael J. Ombrello, C. Egla Rabinovich, Melissa Tesher, Marinka Twilt, Marisa S. Klein‐Gitelman, Fatima Barbar‐Smiley, Ashley M. Cooper, Barbara Edelheit, M. Gillispie-Taylor, Kimberly A. Hays, Melissa L. Mannion, Rosemary Peterson, Elaine Flanagan, Nadine Saad, Nancy Sullivan, Ann Marie Szymanski, Rebecca Trachtman, Marat Turgunbaev, Keila Veiga, Amy S. Turner, James Reston
Издательство: Wiley
Источник: Arthritis Care & Research
Ключевые слова: Autoimmune and Inflammatory Disorders Research, Otitis Media and Relapsing Polychondritis, Ocular Diseases and Behçet’s Syndrome
Другие ссылки: Arthritis Care & Research (HTML)
Deep Blue (University of Michigan) (PDF)
Deep Blue (University of Michigan) (HTML)
Deep Blue (University of Michigan) (PDF)
Deep Blue (University of Michigan) (HTML)
PubMed Central (HTML)
PubMed (HTML)