scholarly journals 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non‐Systemic Polyarthritis, Sacroiliitis, and Enthesitis

2019 ◽  
Vol 71 (6) ◽  
pp. 846-863 ◽  
Author(s):  
Sarah Ringold ◽  
Sheila T. Angeles‐Han ◽  
Timothy Beukelman ◽  
Daniel Lovell ◽  
Carlos A. Cuello ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Therapeutic Approaches ◽  
Arthritis Foundation ◽  
American College Of Rheumatology

scholarly journals 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis

2019 ◽  
Vol 71 (6) ◽  
pp. 864-877 ◽  
Author(s):  
Sheila T. Angeles‐Han ◽  
Sarah Ringold ◽  
Timothy Beukelman ◽  
Daniel Lovell ◽  
Carlos A. Cuello ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Arthritis Foundation ◽  
American College Of Rheumatology

scholarly journals 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis

2019 ◽  
Vol 71 (6) ◽  
pp. 703-716 ◽  
Author(s):  
Sheila T. Angeles‐Han ◽  
Sarah Ringold ◽  
Timothy Beukelman ◽  
Daniel Lovell ◽  
Carlos A. Cuello ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Arthritis Foundation ◽  
American College Of Rheumatology

Principles of management of juvenile idiopathic arthritis

2013 ◽  
pp. 725-733 ◽  
Author(s):  
Nicolino Ruperto ◽  
Angelo Ravelli
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Disease Control ◽  
Physical Therapist ◽  
Well Being ◽  
Standards Of Care ◽  
Pharmacological Interventions ◽  
American College Of Rheumatology ◽  
Systemic Corticosteroids ◽  
Biologic Response ◽  
Disease Modifying

The management of juvenile idiopathic arthritis (JIA) is based on a combination of pharmacological interventions, physical and occupational therapy, and psychosocial support. Ideally, the management is conducted by a multidisciplinary team composed by a paediatric rheumatologist, specialist nurse, physical therapist, occupational therapist, and psychologist. The treatment is aimed to achieve disease control, to relieve pain, to foster normal nutrition and growth, to maintain physical and psychological well-being, and to prevent long-term damage related to the disease or its therapy. First-line pharmacological interventions are based on non-steroidal anti-inflammatory drugs and intra-articular corticosteroids. Patients who are refractory to these therapies are candidates to receive disease-modifying anti-rheumatic medications, namely methotrexate or, in case of enthesitis-related arthritis, sulfasalazine. If therapeutic response is inadequate or suboptimal, the introduction of a biologic response modifier is considered. Systemic corticosteroids are used in selected instances, which include the management of extra-articular manifestations of systemic arthritis or the achievement of quick disease control while are awaiting the full therapeutic effect of a disease-modifying agent in patients with severe polyarthritis. To help physician select the safest and most effective treatment for JIA, the American College of Rheumatology (ACR) has issued a set of recommendations that were meant to be as evidence based as possible. The British Society for Paediatric and Adolescent Rheumatology (BSPAR) has developed the standards of care for patients with JIA, which are aimed to help the paediatric rheumatology teams to improve the service they provide.

scholarly journals Long-term follow-up on effectiveness and safety of etanercept in juvenile idiopathic arthritis: the Dutch national register

2008 ◽  
Vol 68 (5) ◽  
pp. 635-641 ◽  
Author(s):  
F H M Prince ◽  
M Twilt ◽  
R ten Cate ◽  
M A J van Rossum ◽  
W Armbrust ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Adverse Events ◽  
Rheumatoid Factor ◽  
Serious Adverse Events ◽  
American College Of Rheumatology ◽  
Systemic Jia ◽  
Long Term Follow Up ◽  
Remission Criteria

Objective:We undertook an observational study to obtain a complete overview of the long-term effectiveness and safety of etanercept in patients with different juvenile idiopathic arthritis (JIA) subtypes.Methods:At baseline we collected patient and disease characteristics of all Dutch patients with JIA who started treatment with etanercept. Disease activity was evaluated (at start of the study, after 3 months and then yearly) according to the JIA core set of the American College of Rheumatology paediatric definition for 30, 50 and 70% improvement (ACR Pedi 30, 50 and 70). Use of etanercept and concomitant drugs was monitored. Adverse events were recorded.Results:We included 146 patients with JIA with a median follow-up of 2.5 years per patient (range 0.3–7.3). JIA subtypes represented: 27% systemic, 8% polyarticular rheumatoid factor positive, 38% polyarticular rheumatoid factor negative, 19% oligoarticular extended, 3% enthesitis-related and 5% psoriatica. Most patients (77%) met the criteria of the ACR Pedi 30 in the first 3 months of treatment. For the majority of patients this improvement was sustained; 53 (36%) of all patients met the remission criteria. No other second-line agents were needed in 43 patients. Although patients with systemic JIA responded initially less to etanercept therapy than patients from other subtypes, those who did respond showed equal effectiveness in the long term. Serious adverse events rate was low (0.029 per patient year).Conclusions:Etanercept is effective and safe in JIA, even for a large proportion of the patients with systemic JIA. The greatest improvement occurred in the first 3 months of treatment, and was sustained for a long time in most patients (up to 75 months).

scholarly journals American College of Rheumatology provisional criteria for defining clinical inactive disease in select categories of juvenile idiopathic arthritis

2011 ◽  
Vol 63 (7) ◽  
pp. 929-936 ◽  
Author(s):  
Carol A. Wallace ◽  
Edward H. Giannini ◽  
Bin Huang ◽  
Lukasz Itert ◽  
Nicolino Ruperto ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Inactive Disease ◽  
American College Of Rheumatology

scholarly journals Patterns of etanercept use in juvenile idiopathic arthritis in the Childhood Arthritis and Rheumatology Research Alliance Registry

2021 ◽  
Vol 19 (1) ◽  
Author(s):  
Timothy Beukelman ◽  
Aimee Lougee ◽  
Roland A. Matsouaka ◽  
David Collier ◽  
Dax G. Rumsey ◽  
...  
Keyword(s):  
Juvenile Idiopathic Arthritis ◽  
Combination Therapy ◽  
Rheumatology Research ◽  
Childhood Arthritis ◽  
American College Of Rheumatology ◽  
Persistence Rates ◽  
Biologic Dmard ◽  
Parametric Statistics ◽  
Research Alliance ◽  
Rheumatic Drug

Abstract Background We aimed to characterize etanercept (ETN) use in juvenile idiopathic arthritis (JIA) patients enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry. Methods The CARRA Registry is a convenience cohort of patients with paediatric onset rheumatic diseases, including JIA. JIA patients treated with ETN for whom the month and year of ETN initiation were available were included. Patterns of ETN and methotrexate (MTX) use were categorized as follows: combination therapy (ETN and MTX started concurrently), step-up therapy (MTX started first and ETN added later), switchers (MTX started and then stopped when or before ETN started), MTX add-on (ETN started first and MTX added later), and ETN only (no MTX use). Data were described using parametric and non-parametric statistics as appropriate. Results Two thousand thirty-two of the five thousand six hundred forty-one patients with JIA met inclusion criteria (74% female, median age at diagnosis 6.0 years [interquartile range 2.0, 11.0]. Most patients (66.9%) were treated with a non-biologic disease modifying anti-rheumatic drug (DMARD), primarily MTX, prior to ETN. There was significant variability in patterns of MTX use prior to starting ETN. Step-up therapy was the most common approach. Only 34.0% of persistent oligoarticular JIA patients continued treatment with a non-biologic DMARD 3 months or more after ETN initiation. ETN persistence overall was 66.3, 49.4, and 37.3% at 24, 36 and 48 months respectively. ETN persistence among spondyloarthritis patients (enthesitis related arthritis and psoriatic JIA) varied by MTX initiation pattern, with higher ETN persistence rates in those who initiated combination therapy (68.9%) and switchers/ETN only (73.3%) patients compared to step-up (65.4%) and MTX add-on (51.1%) therapy. Conclusion This study characterizes contemporary patterns of ETN use in the CARRA Registry. Treatment was largely in keeping with American College of Rheumatology guidelines.

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