An Australian Living Guideline for the Management of Juvenile Idiopathic Arthritis

Published by Dr Vanessa Glennon on Jan 16, 2025

Disclaimer

These clinical guidelines have been informed by the highest quality evidence available at the time of compilation. Accordingly, the parties involved in the development of these guidelines shall have no liability to any users of the information contained in this publication for any loss or damage, cost or expense incurred or arising from reliance on the information contained in this publication.

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Abstract

An Australian Living Guideline for the Management of Juvenile Idiopathic Arthritis seeks to present the best available, current scientific evidence to assist decision making in the management of JIA. The guideline offers recommended courses of action subject to clinical judgement and patient preferences.

Language

en-au

PICOS

PICO 10.1

Population
Children and young people with JIA
Intervention
Oral methotrexate (5 to 15mg/m2 BSA)
Comparator
Placebo
Outcomes

PICO 10.1

Population
Children and young people with JIA in clinical remission receiving csDMARD therapy
Intervention
Dose reduction of csDMARDs
Comparator
Continuation of csDMARDs
Outcomes

PICO 10.1

Population
Children and young people with JIA
Intervention
Custom foot orthoses
Comparator
Sham or usual care
Outcomes

PICO 10.1

Population
Children and young people with JIA with active arthritis commencing a new disease modifying anti-rheumatic drug (DMARD)
Intervention
Glucocorticoids
Comparator
Placebo or no glucocorticoids
Outcomes

PICO 10.2

Population
Children and young people with JIA
Intervention
Oral methotrexate (15mg/m2 BSA) + IA glucocorticoid
Comparator
IA glucocorticoid alone
Outcomes

PICO 10.2

Population
Children and young people with JIA
Intervention
Custom foot orthoses
Comparator
Shoes
Outcomes

PICO 10.2

Population
Children and young people with JIA in clinical remission receiving csDMARD therapy
Intervention
Discontinuation of csDMARDs
Comparator
Continuation of csDMARDs
Outcomes

PICO 10.3

Population
Children and young people with JIA
Intervention
Oral methotrexate (0.5mg/kg/week)
Comparator
Leflunomide (20kg body weight - 100mg for 1 day, then 10mg every other day maintenance dose; 20-40kg body weight - 100mg for 2 days followed by 10mg/day; >40kg body weight - 100mg for 3 days followed by 20mg/d maintenance dose)
Outcomes

PICO 10.3

Population
Children and young people with JIA
Intervention
Prefabricated foot orthoses
Comparator
Shoes
Outcomes

PICO 10.4

Population
Children and young people with JIA
Intervention
Custom foot orthoses
Comparator
Prefabricated foot orthoses
Outcomes

PICO 20.1

Population
Children and young people with juvenile idiopathic arthritis with active arthritis
Intervention
Intraarticular triamcinolone hexacetonide
Comparator
No intraarticular glucocorticoid
Outcomes

PICO 20.1

Population
Children and young people with JIA
Intervention
Exercise therapy
Comparator
Placebo
Outcomes

PICO 20.2

Population
Children and young people with juvenile idiopathic arthritis with active arthritis
Intervention
Triamcinolone hexacetonide
Comparator
Alternative intraarticular glucocorticoid
Outcomes

PICO 20.2

Population
Children and young people with JIA
Intervention
Exercise therapy
Comparator
No additional treatment (includes wait list, no intervention, usual care)
Outcomes

PICO 20.3

Population
Children and young people with juvenile idiopathic arthritis undergoing intra-articular joint injection
Intervention
Topical anaesthesia
Comparator
placebo
Outcomes

PICO 20.3

Population
Children and young people with JIA
Intervention
Exercise therapy
Comparator
Different exercise therapy
Outcomes

PICO 20.4

Population
Children and young people with juvenile idiopathic arthritis undergoing intraarticular joint injection
Intervention
Topical anaesthesia with subcutaneous local anaesthesia
Comparator
Topical anaesthesia alone
Outcomes

PICO 30.1

Population
Children and young people with a diagnosis of juvenile idiopathic arthritis (JIA) as per the International League Against Rheumatism (ILAR) criteria or earlier equivalents who have JIA associated uveitis that is inadequately controlled by methotrexate Arthritis, Juvenile D001171, Uveitis D014605,
Intervention
Any biologic or targeted synthetic disease modifying anti-rheumatic drug Arthritis, Juvenile D001171, Uveitis D014605,
Comparator
Placebo Arthritis, Juvenile D001171, Uveitis D014605,
Outcomes
Arthritis, Juvenile D001171, Uveitis D014605,