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JIA guidelines push for timely immunization, early biologic use, fewer corticosteroids

Healio Rheumatology reports the authors of the 2020 American College of Rheumatology juvenile idiopathic arthritis (JIA) guidelines emerged with 47 recommendations, emphasizing the early use of biologics, regular immunizations and reduced reliance on corticosteroids. HSS chief of pediatric rheumatology, Karen Brandt Onel, MD, and others, aimed to develop a document that was timely, relevant and feasible in clinical practice. The guidelines cover oligoarthritis, temporomandibular joint (TMJ) arthritis and systemic JIA with or without macrophage activation syndrome (MAS).

“The strength of those recommendations is largely conditional,” explained Dr. Onel. “The quality of supporting evidence is largely very low,” she added. “Similar to the RA [rheumatoid arthritis] guidelines, although we know that corticosteroids are important, especially for children as regards growth stunting and weakened bones, we really try to avoid their use whenever possible so that was a critical part of what we presented,” noted Dr. Onel. “Secondly, strong recommendations for immunizations. Thirdly, early use of biologics, especially for children with systemic juvenile arthritis. And our first toe into the water of recommending stopping medications when children [exhibited inactive disease]. These were crucially important and I think really represent an advance forward,” she said.

Read the full article at Healio.com/news/rheumatology.

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