Update of evidence- and consensus-based guidelines for the treatment of juvenile idiopathic arthritis (JIA) by the German Society of Pediatric and Juvenile Rheumatic Diseases (GKJR): New perspectives on interdisciplinary care

Prasad T Oommen; Timmy Strauss; Karen Baltruschat; Ivan Foeldvari; Christoph Deuter; Gerd Ganser; Johannes-Peter Haas; Claas Hinze; Dirk Holzinger; Anton Hospach; Hans-Iko Huppertz; Arnold Illhardt; Michael Jung; Tilmann Kallinich; Ariane Klein; Kirsten Minden; Kirsten Mönkemöller; Sonja Mrusek; Ulrich Neudorf; Gregor Dückers; Tim Niehues; Matthias Schneider; Philipp Schoof; Angelika Thon; Michael Wachowsky; Norbert Wagner; Susanne Bloedt; Michaël Hofer; Klaus Tenbrock; Catharina Schuetz

doi:10.1016/j.clim.2022.109143

Update of evidence- and consensus-based guidelines for the treatment of juvenile idiopathic arthritis (JIA) by the German Society of Pediatric and Juvenile Rheumatic Diseases (GKJR): New perspectives on interdisciplinary care

Clin Immunol. 2022 Dec:245:109143. doi: 10.1016/j.clim.2022.109143. Epub 2022 Sep 30.

Authors

Prasad T Oommen¹, Timmy Strauss², Karen Baltruschat³, Ivan Foeldvari⁴, Christoph Deuter⁵, Gerd Ganser⁶, Johannes-Peter Haas⁷, Claas Hinze⁸, Dirk Holzinger⁹, Anton Hospach¹⁰, Hans-Iko Huppertz¹¹, Arnold Illhardt⁶, Michael Jung¹², Tilmann Kallinich¹³, Ariane Klein¹⁴, Kirsten Minden¹⁵, Kirsten Mönkemöller¹⁶, Sonja Mrusek¹⁷, Ulrich Neudorf¹⁸, Gregor Dückers¹⁹, Tim Niehues¹⁹, Matthias Schneider²⁰, Philipp Schoof²¹, Angelika Thon²², Michael Wachowsky²³, Norbert Wagner²⁴, Susanne Bloedt²⁵, Michaël Hofer²⁶, Klaus Tenbrock²⁴, Catharina Schuetz²

Affiliations

¹ Department of Pediatric Oncology, Hematology and Clinical Immunology, Division of Pediatric Rheumatology, University Hospital, Medical Faculty, Heinrich Heine University, Düsseldorf, Germany. Electronic address: Prasad.Oommen@med.uni-duesseldorf.de.
² Department of Pediatrics, Medical Faculty Carl Gustav Carus, Dresden, Germany.
³ German Rheumatism League, Bonn, Germany.
⁴ Center for Pediatric and Adolescent Rheumatology, Hamburg, Germany.
⁵ University Hospital Tuebingen, Centre for Ophthalmology, Germany.
⁶ St. Josef Stift Sendenhorst, Center for Pediatric and Adolescent Rheumatology, Germany.
⁷ German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.
⁸ Department of Pediatric Rheumatology and Immunology, University Hospital, Münster, Germany.
⁹ Department of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, Germany; Department of Applied Health Sciences, University of Applied Sciences Bochum, Bochum, Germany.
¹⁰ Center for Pediatric Rheumatology, Clinic Stuttgart, Germany.
¹¹ Department of Pediatrics, Prof.-Hess Children´s Hospital, Bremen, Germany.
¹² Fresenius University of Applied Sciences, Frankfurt/Main, Germany.
¹³ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Berlin, Germany.
¹⁴ Department of Pediatrics, Asklepios Kinderklinik Sankt Augustin, Sankt Augustin, Germany.
¹⁵ Charité - Universitätsmedizin Berlin, corporate member of Freie Universität Berlin and Humboldt- Universität zu Berlin, Department of Pediatric Respiratory Medicine, Immunology and Critical Care Medicine, Berlin, Germany; German Rheumatism Research Center, Berlin, Germany.
¹⁶ Department of Pediatrics, Kinderkrankenhaus Amsterdamer Strasse, Cologne, Germany.
¹⁷ Child and Adolescent Rheumatology, Baden-Baden, Germany.
¹⁸ Department of Pediatric Hematology-Oncology, University of Duisburg-Essen, Essen, Germany.
¹⁹ Helios Klinikum Krefeld, Department of Pediatrics, Germany.
²⁰ Policlinic and Hiller Research Unit for Rheumatology, Medical Faculty and University Hospital Düsseldorf, Heinrich Heine University Düsseldorf, Germany.
²¹ Private office for general pediatrics, pediatric rheumatology, pediatric neurology, Ph. Schoof und Dr. A. Müller, Cosimastrasse 106, 81927 München, Germany.
²² Department of Paediatric Pneumology, Allergology and Neonatology, Children's Hospital, Medical School, Hannover, Germany.
²³ Clinic Rummelsberg, Department of Orthopedics, Germany.
²⁴ RWTH Aachen, Department of Pediatrics, Germany.
²⁵ Association of Scientific Medical Associations (AWMF), Germany.
²⁶ Unité d'immuno-allergologie et rhumatologie, Unité Romande d'Immuno-Rhumatologie Pédiatrique, Service de Pédiatrie, CHUV, 1011 Lausanne, Switzerland.

PMID: 36191738
DOI: 10.1016/j.clim.2022.109143

Abstract

Background: New therapeutic strategies for juvenile idiopathic arthritis (JIA) have evolved within the past ten years, and as a result, an update of the 2011 recommendations of the German management guidelines was initiated.

Methods: A systemic literature review was performed, overarching principles were proposed and pre-selected via an online survey followed by two multidisciplinary consensus conferences. Pharmacological and non-pharmacological treatments were discussed, statements were proposed and ultimately agreed upon by nominal group technique (NGT).

Results: 12 overarching therapeutic principles, as well as 9 recommendations on pharmacological and 5 on non-pharmacological treatments for JIA were agreed upon.

Conclusion: This report summarizes the recent update of the interdisciplinary, consensus-based German guidelines on the management of JIA. The multi- and interdisciplinary participation of all caregivers was central for this patient-focused update. With these guidelines, physicians can choose an evidence-based approach, which allows better tailored treatment in this vulnerable cohort of children and adolescents.

Keywords: Consensus guidelines; Juvenile idiopathic arthritis (JIA); Management of JIA; Multidisciplinary care.

Publication types

Systematic Review

MeSH terms

Adolescent
Arthritis, Juvenile* / drug therapy
Child
Consensus
Developmental Disabilities
Humans