For a study, the researchers sought to present revised pharmacologic instructions for treating oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic juvenile idiopathic arthritis (JIA) with and without macrophage activation syndrome in JIA. There were additional recommendations for decreasing and stopping medication in inactive systemic JIA. Researchers created patient/population, intervention, comparison, and clinically relevant outcome questions. The Grading of Recommendations Assessment, Development, and Evaluation approach was used to grade the quality of evidence after performing a systematic literature review (high, moderate, low, or very low). A voting panel comprised of clinicians and patients/caregivers agreed on the recommendations’ direction (for or against) and strength (strong or conditional). The JIA recommendations, like those issued in 2019, were based on clinical characteristics of JIA rather than a precise classification scheme. The guideline includes the initial and ongoing therapy of JIA in patients with oligoarthritis, TMJ arthritis, and systemic JIA and for tapering and ceasing medication in patients with inactive systemic JIA. Other aspects of disease management were explored, such as factors that influence treatment selection and medication tapering. All of the evidence for the recommendations was rated as poor or very poor quality. As a result, more than half of the recommendations had a condition attached to them. The 2019 American College of Rheumatology JIA and uveitis guidelines, which targeted polyarthritis, sacroiliitis, enthesitis, and uveitis, complemented the clinical practice guideline. It was intended to assist clinicians, patients, and caregivers in making decisions. The guidelines took into account the severity of both articular and nonarticular symptoms and the patient’s overall quality of life. Although the evidence was generally of poor quality, and many of the recommendations were conditional, the guideline’s relevance and applicability were enhanced by including caregivers and patients in the decision-making process. It was vital to keep in mind that these were only suggestions. The treating doctor and the patient/caregiver should have made clinical decisions, as they should always.
Link:onlinelibrary.wiley.com/doi/full/10.1002/acr.24853
