[New developments in juvenile arthritis]
Aikaterini Koryllou1, Katerina Theodoropoulou1
1Unité d'immunologie, allergologie et rhumatologie pédiatrique, Service de pédiatrie, Département femme-mère-enfant, Centre hospitalier universitaire vaudois, 1011 Lausanne.
Insights
Juvenile idiopathic arthritis (JIA) is a complex childhood joint disease. While new treatments improve outcomes, achieving lasting remission and preventing adult disability requires ongoing multidisciplinary care and transition support.
Area of Science:
- Rheumatology
- Pediatric Immunology
- Inflammatory Diseases
Context:
- Juvenile idiopathic arthritis (JIA) is a chronic, heterogeneous inflammatory joint disease affecting children under 16.
- Systemic JIA is now recognized as the pediatric form of Still's disease.
- Current expert guidelines (PRES/EULAR 2024) recommend prompt treatment, including IL-1/IL-6 blockade and complication screening.
Purpose:
- To highlight the current understanding and management challenges of Juvenile idiopathic arthritis.
- To emphasize the need for improved strategies for achieving and maintaining remission in JIA patients.
- To underscore the importance of a comprehensive approach for long-term patient outcomes.
Summary:
- Despite advancements in pharmacotherapy, achieving durable remission in JIA remains a significant clinical challenge.
- A substantial proportion of JIA patients experience persistent disease activity and physical disability into adulthood.
- Effective management necessitates a multidisciplinary team approach and structured transition programs from pediatric to adult care.
Impact:
- Improved long-term outcomes for JIA patients through optimized treatment and care transitions.
- Reduced physical disability and enhanced quality of life for individuals with JIA.
- Advancement of pediatric rheumatology through evidence-based management strategies and collaborative care models.
Abstract:
Juvenile idiopathic arthritis (JIA) represents a heterogeneous group of chronic inflammatory diseases affecting the joints, beginning before the age of 16 years. Systemic JIA has recently been recognized by experts as the pediatric form of Still's disease; prompt treatment, in particular IL-1 or IL-6 blockade and active screening for complications are recommended (PRES/EULAR 2024). New medications have significantly improved the long-term outcome of JIA. However, achieving and maintaining remission still remains difficult. Durable remission rate in adulthood is low, with physical disability reported in approximately half of patients. Therefore, a multidisciplinary approach and a well-coordinated transition program are essential to ensure the best long-term outcome of these patients.
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