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2011 ACR Recommendations for the Treatment of Juvenile Idiopathic Arthritis

Juvenile Idiopathic Arthritis Begins Before 16th Birthday

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Updated April 09, 2013

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What Is Juvenile Idiopathic Arthritis?

The International League of Associations for Rheumatology (ILAR) has defined juvenile idiopathic arthritis, or JIA, as "arthritis of unknown etiology that begins before the sixteenth birthday and persists for at least 6 weeks with other known conditions excluded." JIA is among the more common chronic diseases associated with childhood. About 1 child per 1,000 develop some form of juvenile arthritis.

Because juvenile idiopathic arthritis can be physically disabling and can go into adulthood, developing a treatment plan to control it is important. The American College of Rheumatology (ACR) has released the 2011 treatment recommendations for juvenile idiopathic arthritis. In order to do this, the ACR created JIA treatment groups. The 5 JIA treatment groups used in the development of the recommendations were:

  • History of arthritis of 4 or fewer joints
  • History of arthritis of 5 or more joints
  • Active sacroiliac arthritis
  • Systemic arthritis with active systemic features (and without active arthritis)
  • Systemic arthritis with active arthritis (and without active systemic features)

Within each treatment group, recommendations depend on disease activity level and presence of certain factors indicating poor prognosis.

The Recommendations

The recommendations cover both when to begin a specific treatment and safety monitoring of the treatments. Recommended treatments for JIA include nonsteroidal anti-inflammatory drugs (NSAIDs), intra-articular glucocorticoid injections, non-biologic disease modifying anti-rheumatic drugs (DMARDs), biologic DMARDs, and systemic glucocorticoids for the treatment of systemic features of juvenile arthritis.

The ACR has easy-to-follow tables that take you through their 2011 recommendations in The Clinician's Guide.

Sources:

2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis: Initiation and Safety Monitoring of Therapeutic Agents for the Treatment of Arthritis and Systemic Features. Full Manuscript. Arthritis Care & Research. Vol. 63, No. 4, April 2011, pp 465-482.

Arthritis in Children. American College of Rheumatology. Leslie S. Abramson, MD. Updated June 2008.
http://www.rheumatology.org/practice/clinical/patients/diseases_and_conditions/juvenilearthritis.asp

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