2013 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis: Recommendations for the Medical Therapy of Children With Systemic Juvenile Idiopathic Arthritis and Tuberculosis Screening Among Children Receiving Biologic Medications

Abstract

Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient. The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient's individual circumstances. Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice. The American College of Rheumatology is an independent, professional, medical and scientific society which does not guarantee, warrant, or endorse any commercial product or service.

The outcomes of juvenile idiopathic arthritis in children managed with contemporary treatments: results from the ReACCh-Out cohort

“…Treatments received by this cohort are largely consistent with current practice recommendations,5 6 24 although the recommendations were published after study recruitment and our study did not dictate the treatments used. The only difference may be a later use of biological therapies for those with poor prognostic features 6 24.…”

“…Treatments received by this cohort are largely consistent with current practice recommendations,5 6 24 although the recommendations were published after study recruitment and our study did not dictate the treatments used. The only difference may be a later use of biological therapies for those with poor prognostic features 6 24. The use of biological agents in our cohort and in current treatment recommendations is less aggressive than in recent trials of early treatment22 23 and a cross-sectional report from the USA 25.…”

The Systemic Juvenile Idiopathic Arthritis Cohort of the Childhood Arthritis and Rheumatology Research Alliance Registry: 2010–2013

“…The move away from DMARD and TNF-α inhibitor therapies likely reflects a combination of factors: lack of efficacy of these agents 35,36 , demonstrated efficacy of IL-1 6,7,9,10,13 and IL-6 inhibitors 5,37 and their approval by the FDA for sJIA, and the publication of the ACR treatment recommendations and CARRA CTP for sJIA 14,38,39 . The move away from DMARD and TNF-α inhibitor therapies likely reflects a combination of factors: lack of efficacy of these agents 35,36 , demonstrated efficacy of IL-1 6,7,9,10,13 and IL-6 inhibitors 5,37 and their approval by the FDA for sJIA, and the publication of the ACR treatment recommendations and CARRA CTP for sJIA 14,38,39 .…”

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

“…The American College of Rheumatology (ACR) published initial recommendations for JIA in 2011 that provided guidance for the treatment of JIA and for the monitoring of select medical therapies, and an update in 2013 focused on the treatment of systemic arthritis (14,15). The ACR has subsequently transitioned from the RAND/ UCLA Appropriateness Method used to generate these prior recommendations to the Grading of Recommendations Assessment, Development and Evaluation (GRADE) methodology, which has the advantages of a more transparent decision-making process and well-defined criteria for moving from evidence to recommendation, including balancing benefits and harms and consideration of patient values and preferences while maintaining methodologic rigor (16).…”