Treating juvenile idiopathic arthritis to target: Recommendations of an international task force
Autor(a) principal: | |
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Data de Publicação: | 2018 |
Outros Autores: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
Tipo de documento: | Artigo |
Idioma: | eng |
Título da fonte: | Repositório Institucional da UNESP |
Texto Completo: | http://dx.doi.org/10.1136/annrheumdis-2018-213030 http://hdl.handle.net/11449/171016 |
Resumo: | 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. |
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Treating juvenile idiopathic arthritis to target: Recommendations of an international task forcejuvenile idiopathic arthritisoutcomes researchtreatmentRecent 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.Clinica Pediatrica e Reumatologia Università degli Studi di Genova Istituto di Ricovero e Cura a Carattere Scientifico Istituto GianninaDepartment of Pediatrics Asklepios Klinik Sankt AugustinDepartment of Pediatric and Adolescents Medicine University Hospital of CologneDivision od Rheumatology University of Toronto Hospital for Sick ChildrenDivision of Rheumatology Cincinnati Children's Hospital Medical Center University of CincinnatiDepartment of Paediatric Immunology Wilhelmina Children's Hospital University Medical Center Utrecht University of UtrechtRheumatology Unit Department of General Medicine Royal Children's Hospital Murdoch Children's Research InstituteDepartment of Pediatric Rheumatology King Faisal Specialist Hospital and Research Center Alfaisal UniversityDivision of Pediatric Rheumatology Hospital Sant Joan de Déu Universitat de BarcelonaDepartment of Allergology Rheumatology and Clinical Immunology University Medical Center Ljubljana Medical Faculty University of LjubljanaDivision of Rheumatology Western University Children's Hospital London Health Sciences CentreInstitute of Translational Medicine University of Liverpool Alder Hey Children's NHS Foundation TrustRheumatology Department Hospital General de México Eduardo LiceagaPediatric Rheumatology Azienda Ospedaliero Universitaria MeyerDivision of Rheumatology Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino GesùPediatric Rheumatology and Immunology University of MuensterDepartment of Pediatrics Nippon Medical SchoolInstitute of Clinical Medicine Children's Hospital Helsinki University HospitalParis-Descartes University IMAGINE Institute RAISE 22 National Reference Centre Necker-Enfants Malades Hospital Assistance Publique Hopitaux de ParisClinica Pediatrica e Reumatologia Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina GasliniServicio de Inmunología y Reumatología Hospital de Pediatría GarrahanReumatologia Pediátrica São Paulo State University (UNESP)Department of Rheumatology ISIC Superspeciality Hospital Sir Ganga Ram HospitalRed Cross War Memorial Children's Hospital University of Cape TownPediatric Rheumatology Seattle Children's Hospital and Research Center University of WashingtonPediatric Rheumatology Unit Department of Pediatrics Meir Medical CenterTel Aviv University Sackler School of MedicineDivision of Rheumatology Department of Medicine3 Medical University of ViennaReumatologia Pediátrica São Paulo State University (UNESP)Istituto GianninaAsklepios Klinik Sankt AugustinUniversity Hospital of CologneHospital for Sick ChildrenUniversity of CincinnatiUniversity of UtrechtMurdoch Children's Research InstituteAlfaisal UniversityUniversitat de BarcelonaUniversity of LjubljanaLondon Health Sciences CentreAlder Hey Children's NHS Foundation TrustHospital General de México Eduardo LiceagaAzienda Ospedaliero Universitaria MeyerOspedale Pediatrico Bambino GesùUniversity of MuensterNippon Medical SchoolHelsinki University HospitalAssistance Publique Hopitaux de ParisIstituto Giannina GasliniHospital de Pediatría GarrahanUniversidade Estadual Paulista (Unesp)Sir Ganga Ram HospitalUniversity of Cape TownUniversity of WashingtonMeir Medical CenterTel Aviv University Sackler School of MedicineMedical University of ViennaRavelli, AngeloConsolaro, AlessandroHorneff, GerdLaxer, Ronald M.Lovell, Daniel J.Wulffraat, Nico M.Akikusa, Jonathan D.Al-Mayouf, Sulaiman M.Antón, JordiAvcin, TadejBerard, Roberta A.Beresford, Michael W.Burgos-Vargas, RubenCimaz, RolandoDe Benedetti, FabrizioDemirkaya, ErkanFoell, DirkItoh, YasuhikoLahdenne, PekkaMorgan, Esi M.Quartier, PierreRuperto, NicolinoRusso, RicardoSaad-Magalhães, Claudia [UNESP]Sawhney, SujataScott, ChristiaanShenoi, SusanSwart, Joost F.Uziel, YosefVastert, Sebastiaan J.Smolen, Josef S.2018-12-11T16:53:21Z2018-12-11T16:53:21Z2018-06-01info:eu-repo/semantics/publishedVersioninfo:eu-repo/semantics/article819-828application/pdfhttp://dx.doi.org/10.1136/annrheumdis-2018-213030Annals of the Rheumatic Diseases, v. 77, n. 6, p. 819-828, 2018.1468-20600003-4967http://hdl.handle.net/11449/17101610.1136/annrheumdis-2018-2130302-s2.0-850472726172-s2.0-85047272617.pdf70983100083716320000-0002-7631-7093Scopusreponame:Repositório Institucional da UNESPinstname:Universidade Estadual Paulista (UNESP)instacron:UNESPengAnnals of the Rheumatic Diseases7,6997,699info:eu-repo/semantics/openAccess2023-12-10T06:15:02Zoai:repositorio.unesp.br:11449/171016Repositório InstitucionalPUBhttp://repositorio.unesp.br/oai/requestopendoar:29462024-08-05T19:53:33.722029Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP)false |
dc.title.none.fl_str_mv |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
title |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
spellingShingle |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force Ravelli, Angelo juvenile idiopathic arthritis outcomes research treatment |
title_short |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
title_full |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
title_fullStr |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
title_full_unstemmed |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
title_sort |
Treating juvenile idiopathic arthritis to target: Recommendations of an international task force |
author |
Ravelli, Angelo |
author_facet |
Ravelli, Angelo Consolaro, Alessandro Horneff, Gerd Laxer, Ronald M. Lovell, Daniel J. Wulffraat, Nico M. Akikusa, Jonathan D. Al-Mayouf, Sulaiman M. Antón, Jordi Avcin, Tadej Berard, Roberta A. Beresford, Michael W. Burgos-Vargas, Ruben Cimaz, Rolando De Benedetti, Fabrizio Demirkaya, Erkan Foell, Dirk Itoh, Yasuhiko Lahdenne, Pekka Morgan, Esi M. Quartier, Pierre Ruperto, Nicolino Russo, Ricardo Saad-Magalhães, Claudia [UNESP] Sawhney, Sujata Scott, Christiaan Shenoi, Susan Swart, Joost F. Uziel, Yosef Vastert, Sebastiaan J. Smolen, Josef S. |
author_role |
author |
author2 |
Consolaro, Alessandro Horneff, Gerd Laxer, Ronald M. Lovell, Daniel J. Wulffraat, Nico M. Akikusa, Jonathan D. Al-Mayouf, Sulaiman M. Antón, Jordi Avcin, Tadej Berard, Roberta A. Beresford, Michael W. Burgos-Vargas, Ruben Cimaz, Rolando De Benedetti, Fabrizio Demirkaya, Erkan Foell, Dirk Itoh, Yasuhiko Lahdenne, Pekka Morgan, Esi M. Quartier, Pierre Ruperto, Nicolino Russo, Ricardo Saad-Magalhães, Claudia [UNESP] Sawhney, Sujata Scott, Christiaan Shenoi, Susan Swart, Joost F. Uziel, Yosef Vastert, Sebastiaan J. Smolen, Josef S. |
author2_role |
author author author author author author author author author author author author author author author author author author author author author author author author author author author author author author |
dc.contributor.none.fl_str_mv |
Istituto Giannina Asklepios Klinik Sankt Augustin University Hospital of Cologne Hospital for Sick Children University of Cincinnati University of Utrecht Murdoch Children's Research Institute Alfaisal University Universitat de Barcelona University of Ljubljana London Health Sciences Centre Alder Hey Children's NHS Foundation Trust Hospital General de México Eduardo Liceaga Azienda Ospedaliero Universitaria Meyer Ospedale Pediatrico Bambino Gesù University of Muenster Nippon Medical School Helsinki University Hospital Assistance Publique Hopitaux de Paris Istituto Giannina Gaslini Hospital de Pediatría Garrahan Universidade Estadual Paulista (Unesp) Sir Ganga Ram Hospital University of Cape Town University of Washington Meir Medical Center Tel Aviv University Sackler School of Medicine Medical University of Vienna |
dc.contributor.author.fl_str_mv |
Ravelli, Angelo Consolaro, Alessandro Horneff, Gerd Laxer, Ronald M. Lovell, Daniel J. Wulffraat, Nico M. Akikusa, Jonathan D. Al-Mayouf, Sulaiman M. Antón, Jordi Avcin, Tadej Berard, Roberta A. Beresford, Michael W. Burgos-Vargas, Ruben Cimaz, Rolando De Benedetti, Fabrizio Demirkaya, Erkan Foell, Dirk Itoh, Yasuhiko Lahdenne, Pekka Morgan, Esi M. Quartier, Pierre Ruperto, Nicolino Russo, Ricardo Saad-Magalhães, Claudia [UNESP] Sawhney, Sujata Scott, Christiaan Shenoi, Susan Swart, Joost F. Uziel, Yosef Vastert, Sebastiaan J. Smolen, Josef S. |
dc.subject.por.fl_str_mv |
juvenile idiopathic arthritis outcomes research treatment |
topic |
juvenile idiopathic arthritis outcomes research treatment |
description |
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. |
publishDate |
2018 |
dc.date.none.fl_str_mv |
2018-12-11T16:53:21Z 2018-12-11T16:53:21Z 2018-06-01 |
dc.type.status.fl_str_mv |
info:eu-repo/semantics/publishedVersion |
dc.type.driver.fl_str_mv |
info:eu-repo/semantics/article |
format |
article |
status_str |
publishedVersion |
dc.identifier.uri.fl_str_mv |
http://dx.doi.org/10.1136/annrheumdis-2018-213030 Annals of the Rheumatic Diseases, v. 77, n. 6, p. 819-828, 2018. 1468-2060 0003-4967 http://hdl.handle.net/11449/171016 10.1136/annrheumdis-2018-213030 2-s2.0-85047272617 2-s2.0-85047272617.pdf 7098310008371632 0000-0002-7631-7093 |
url |
http://dx.doi.org/10.1136/annrheumdis-2018-213030 http://hdl.handle.net/11449/171016 |
identifier_str_mv |
Annals of the Rheumatic Diseases, v. 77, n. 6, p. 819-828, 2018. 1468-2060 0003-4967 10.1136/annrheumdis-2018-213030 2-s2.0-85047272617 2-s2.0-85047272617.pdf 7098310008371632 0000-0002-7631-7093 |
dc.language.iso.fl_str_mv |
eng |
language |
eng |
dc.relation.none.fl_str_mv |
Annals of the Rheumatic Diseases 7,699 7,699 |
dc.rights.driver.fl_str_mv |
info:eu-repo/semantics/openAccess |
eu_rights_str_mv |
openAccess |
dc.format.none.fl_str_mv |
819-828 application/pdf |
dc.source.none.fl_str_mv |
Scopus reponame:Repositório Institucional da UNESP instname:Universidade Estadual Paulista (UNESP) instacron:UNESP |
instname_str |
Universidade Estadual Paulista (UNESP) |
instacron_str |
UNESP |
institution |
UNESP |
reponame_str |
Repositório Institucional da UNESP |
collection |
Repositório Institucional da UNESP |
repository.name.fl_str_mv |
Repositório Institucional da UNESP - Universidade Estadual Paulista (UNESP) |
repository.mail.fl_str_mv |
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1808129135161114624 |