Universität zu Köln

Ravelli, Angelo, Consolaro, Alessandro ORCID: 0000-0002-0065-7614, Horneff, Gerd, Laxer, Ronald M., Lovell, Daniel J., Wulffraat, Nico M., Akikusa, Jonathan D., Al-Mayouf, Sulaiman M., Anton, Jordi ORCID: 0000-0002-8792-4219, Avcin, Tadej, Berard, Roberta A., Beresford, Michael W., Burgos-Vargas, Ruben ORCID: 0000-0003-1058-8955, Cimaz, Rolando, De Benedetti, Fabrizio, Demirkaya, Erkan, Foell, Dirk, Itoh, Yasuhiko ORCID: 0000-0002-4999-6473, Lahdenne, Pekka, Morgan, Esi M., Quartier, Pierre, Ruperto, Nicolino ORCID: 0000-0001-8407-7782, Russo, Ricardo ORCID: 0000-0002-1256-8483, Saad-Magalhaes, Claudia, Sawhney, Sujata, Scott, Christiaan, Shenoi, Susan, Swart, Joost F., Uziel, Yosef, Vastert, Sebastiaan J. and Smolen, Josef S. (2018). Treating juvenile idiopathic arthritis to target: recommendations of an international task force. Ann. Rheum. Dis., 77 (6). S. 819 - 829. LONDON: BMJ PUBLISHING GROUP. ISSN 1468-2060

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Abstract

Recent therapeutic advances in juvenile idiopathic arthritis (JIA) have made remission an achievable goal for most patients. Reaching this target leads to improved outcomes. The objective was to develop recommendations for treating JIA to target. A Steering Committee formulated a set of recommendations based on evidence derived from a systematic literature review. These were subsequently discussed, amended and voted on by an international Task Force of 30 paediatric rheumatologists in a consensus-based, Delphi-like procedure. Although the literature review did not reveal trials that compared a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated development of recommendations. The group agreed on six overarching principles and eight recommendations. The main treatment target, which should be based on a shared decision with parents/patients, was defined as remission, with the alternative target of low disease activity. The frequency and timeline of follow-up evaluations to ensure achievement and maintenance of the target depend on JIA category and level of disease activity. Additional recommendations emphasise the importance of ensuring adequate growth and development and avoiding long-term systemic glucocorticoid administration to maintain the target. All items were agreed on by more than 80% of the members of the Task Force. A research agenda was formulated. The Task Force developed recommendations for treating JIA to target, being aware that the evidence is not strong and needs to be expanded by future research. These recommendations can inform various stakeholders about strategies to reach optimal outcomes for JIA.

Item Type:	Journal Article
Creators:	Creators Email ORCID ORCID Put Code Ravelli, Angelo UNSPECIFIED UNSPECIFIED UNSPECIFIED Consolaro, Alessandro UNSPECIFIED orcid.org/0000-0002-0065-7614 UNSPECIFIED Horneff, Gerd UNSPECIFIED UNSPECIFIED UNSPECIFIED Laxer, Ronald M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Lovell, Daniel J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Wulffraat, Nico M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Akikusa, Jonathan D. UNSPECIFIED UNSPECIFIED UNSPECIFIED Al-Mayouf, Sulaiman M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Anton, Jordi UNSPECIFIED orcid.org/0000-0002-8792-4219 UNSPECIFIED Avcin, Tadej UNSPECIFIED UNSPECIFIED UNSPECIFIED Berard, Roberta A. UNSPECIFIED UNSPECIFIED UNSPECIFIED Beresford, Michael W. UNSPECIFIED UNSPECIFIED UNSPECIFIED Burgos-Vargas, Ruben UNSPECIFIED orcid.org/0000-0003-1058-8955 UNSPECIFIED Cimaz, Rolando UNSPECIFIED UNSPECIFIED UNSPECIFIED De Benedetti, Fabrizio UNSPECIFIED UNSPECIFIED UNSPECIFIED Demirkaya, Erkan UNSPECIFIED UNSPECIFIED UNSPECIFIED Foell, Dirk UNSPECIFIED UNSPECIFIED UNSPECIFIED Itoh, Yasuhiko UNSPECIFIED orcid.org/0000-0002-4999-6473 UNSPECIFIED Lahdenne, Pekka UNSPECIFIED UNSPECIFIED UNSPECIFIED Morgan, Esi M. UNSPECIFIED UNSPECIFIED UNSPECIFIED Quartier, Pierre UNSPECIFIED UNSPECIFIED UNSPECIFIED Ruperto, Nicolino UNSPECIFIED orcid.org/0000-0001-8407-7782 UNSPECIFIED Russo, Ricardo UNSPECIFIED orcid.org/0000-0002-1256-8483 UNSPECIFIED Saad-Magalhaes, Claudia UNSPECIFIED UNSPECIFIED UNSPECIFIED Sawhney, Sujata UNSPECIFIED UNSPECIFIED UNSPECIFIED Scott, Christiaan UNSPECIFIED UNSPECIFIED UNSPECIFIED Shenoi, Susan UNSPECIFIED UNSPECIFIED UNSPECIFIED Swart, Joost F. UNSPECIFIED UNSPECIFIED UNSPECIFIED Uziel, Yosef UNSPECIFIED UNSPECIFIED UNSPECIFIED Vastert, Sebastiaan J. UNSPECIFIED UNSPECIFIED UNSPECIFIED Smolen, Josef S. UNSPECIFIED UNSPECIFIED UNSPECIFIED
URN:	urn:nbn:de:hbz:38-185233
DOI:	10.1136/annrheumdis-2018-213030
Journal or Publication Title:	Ann. Rheum. Dis.
Volume:	77
Number:	6
Page Range:	S. 819 - 829
Date:	2018
Publisher:	BMJ PUBLISHING GROUP
Place of Publication:	LONDON
ISSN:	1468-2060
Language:	English
Faculty:	Unspecified
Divisions:	Unspecified
Subjects:	no entry
Uncontrolled Keywords:	Keywords Language OF-RHEUMATOLOGY RECOMMENDATIONS; INTERLEUKIN-1 RECEPTOR ANTAGONIST; MINIMAL DISEASE-ACTIVITY; CLINICAL REMISSION; DEFINING CRITERIA; INACTIVE DISEASE; DOUBLE-BLIND; DEVELOPING STANDARDS; SELECT CATEGORIES; ACTIVITY STATES Multiple languages Rheumatology Multiple languages
Refereed:	Yes
URI:	http://kups.ub.uni-koeln.de/id/eprint/18523