What is low-dose corticosteroid therapy in juvenile idiopathic arthritis? A worldwide, questionnaire-based survey

Area of Science:

• Pediatric Rheumatology
• Pharmacology
• Clinical Practice Guidelines

Background:

• Juvenile idiopathic arthritis (JIA) is a chronic autoimmune disease requiring long-term management.
• Corticosteroids are frequently used in JIA treatment, but definitions of 'low-dose' and 'long-term' vary.
• Establishing a consensus on corticosteroid dosing is crucial for consistent patient care.

Purpose of the Study:

• To investigate pediatric rheumatologists' personal definitions of low-dose, long-term corticosteroid therapy for JIA.
• To identify variations in these definitions across different geographical regions.
• To highlight the need for a standardized definition in JIA management.

Main Methods:

• A standardized questionnaire was distributed to pediatric rheumatologists globally.
• Participants were asked to provide their personal definition of low-dose, long-term corticosteroid therapy for JIA.
• Responses were collected and analyzed from multiple continents, including North America, Europe, the Near East, and Australia.

Main Results:

• Ninety-two evaluable responses were received from 99 questionnaires.
• The average definition of low-dose, long-term corticosteroid therapy was 0.26 +/- 0.14 mg prednisolone/kg body weight/day.
• Significant regional variations in dosage definitions were observed, with Central Europe reporting lower dosages compared to other regions.

Conclusions:

• There is a wide range in pediatric rheumatologists' personal definitions of low-dose, long-term corticosteroid therapy for JIA.
• The reasons for these variations and their clinical impact on patients require further investigation.
• Development and validation of a universally accepted definition for low-dose, long-term corticosteroid therapy in JIA are recommended.