Forum for Science, Industry and Business

Sponsored by:     3M 
Search our Site:


Recommendations guide physicians in treatment of systemic juvenile arthritis

In the U.S., there are nearly 300,000 children with juvenile arthritis and other rheumatic illnesses according to estimates from the American College of Rheumatology (ACR).

For pediatric patients with systemic juvenile idiopathic arthritis (JIA), effective treatment for this disabling disease is imperative. New treatment recommendations that guide physicians caring for children with systemic JIA are now published in the ACR journals, Arthritis & Rheumatism and Arthritis Care & Research.

Systemic JIA is defined by the International League of Associations for Rheumatology as arthritis in one or more joints for at least six weeks in children sixteen years of age or younger. The arthritis is accompanied or preceded by fever for at least two-weeks that is daily ("quotidian") for at least 3 of those days, with one or more of the following symptoms: red rash (evanescent erythematous rash), enlarged liver, spleen or lymph nodes, and inflammation of the tissue lining (serositis) of the lungs, heart, or stomach. Medical evidence suggests that systemic JIA accounts for 4% to 15% of all JIA cases.

Each year the ACR reviews its current guidelines to ensure that they are up to date. In 2012, the ACR determined that an update to the 2011 JIA recommendations—specifically for treatment of systemic JIA—was needed. A new team that included researchers who worked on the original JIA guideline was assembled to develop the 2013 update. Investigators, led by Dr. Pamela Weiss from Children's Hospital of Philadelphia in Pennsylvania and Dr. Sarah Ringold from the Seattle Children's Hospital in Washington, conducted a systematic review of medical literature through January 2013.

The new recommendations for systemic JIA are based upon more than 1,200 clinical scenarios and include recommendations for use of the following medications:

Non-steroidal anti-inflammatory drugs (NSAIDs)
Intravenous immunoglobulin (IVIG)
Calcineurin inhibitors
Tumor necrosis factor alpha (TNFá) inhibitors
Canakinumab *
Rilonacept *
Tocilizumab *
*New addition to the 2013 update
They include treatment options for patients with and without active systemic disease, along with varying degrees of inflammation of the joint lining (synovitis), as well as recommendations for repeat TB screening for JIA patients receiving biologics. Dr. Weiss concludes, "The 2013 recommendations address specific disease characteristics and reflect the commitment to enhancing care of children with systemic JIA."

This work was funded by the American College of Rheumatology, and investigators' time was supported in part by grants from the National Institute of Arthritis and Musculoskeletal and Skin Disease, NIH (grant1-K23-AR059749-01A) and the Agency for Healthcare Research and Quality (grant K12HS019482).

This study is published in Arthritis Care & Research and Arthritis & Rheumatism. Media wishing to receive a PDF of this article may contact

Full citation: "2013 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis. Recommendations for the Medical Therapy of Children with Systemic Juvenile Idiopathic Arthritis and Tuberculosis Screening Among Children Receiving Biologic Medications." Sarah Ringold, Pamela F. Weiss, Timothy Beukelman, Esi Morgan DeWitt, Norman T. Ilowite, Yukiko Kimura, Ronald M. Laxer, Daniel J. Lovell, Peter A. Nigrovic, Angela Byun Robinson and Richard K. Vehe. Arthritis & Rheumatism (DOI: 10.1002/art.38092). Arthritis Care & Research (DOI: 10.1002/acr.22087); Published Online: September 24, 2013.

URL Upon Publication: and

About the Author: To arrange an interview with Dr. Ringold, please contact Media wishing to speak with Dr. Weiss may contact Jennifer Long at or +1 215-590-2105.

About the Journals

Arthritis & Rheumatism is an official journal of the American College of Rheumatology (ACR) and covers all aspects of inflammatory disease. The American College of Rheumatology ( is the professional organization whose members share a dedication to healing, preventing disability, and curing the more than 100 types of arthritis and related disabling and sometimes fatal disorders of the joints, muscles, and bones. Members include practicing physicians, research scientists, nurses, physical and occupational therapists, psychologists, and social workers. The journal is published by Wiley on behalf of the ACR. For more information, please visit

Arthritis Care & Research is an official journal of the American College of Rheumatology (ACR), and the Association of Rheumatology Health Professionals (ARHP), a division of the College. Arthritis Care & Research is a peer-reviewed journal that publishes both original research and review articles that promote excellence in the clinical practice of rheumatology. Relevant to the care of individuals with arthritis and related disorders, major topics are evidence-based practice studies, clinical problems, practice guidelines, health care economics, health care policy, educational, social, and public health issues, and future trends in rheumatology practice. The journal is published by Wiley on behalf of the ACR. For more information, please visit the journal home page at

About Wiley

Wiley is a global provider of content-enabled solutions that improve outcomes in research, education, and professional practice. Our core businesses produce scientific, technical, medical, and scholarly journals, reference works, books, database services, and advertising; professional books, subscription products, certification and training services and online applications; and education content and services including integrated online teaching and learning resources for undergraduate and graduate students and lifelong learners.

Founded in 1807, John Wiley & Sons, Inc. (NYSE: JWa, JWb), has been a valued source of information and understanding for more than 200 years, helping people around the world meet their needs and fulfill their aspirations. Wiley and its acquired companies have published the works of more than 450 Nobel laureates in all categories: Literature, Economics, Physiology or Medicine, Physics, Chemistry, and Peace. Wiley's global headquarters are located in Hoboken, New Jersey, with operations in the U.S., Europe, Asia, Canada, and Australia.

Dawn Peters | EurekAlert!
Further information:

More articles from Health and Medicine:

nachricht Scientists develop tiny tooth-mounted sensors that can track what you eat
22.03.2018 | Tufts University

nachricht NIH scientists describe potential antibody treatment for multidrug-resistant K. pneumoniae
14.03.2018 | NIH/National Institute of Allergy and Infectious Diseases

All articles from Health and Medicine >>>

The most recent press releases about innovation >>>

Die letzten 5 Focus-News des innovations-reports im Überblick:

Im Focus: Researchers Discover New Anti-Cancer Protein

An international team of researchers has discovered a new anti-cancer protein. The protein, called LHPP, prevents the uncontrolled proliferation of cancer cells in the liver. The researchers led by Prof. Michael N. Hall from the Biozentrum, University of Basel, report in “Nature” that LHPP can also serve as a biomarker for the diagnosis and prognosis of liver cancer.

The incidence of liver cancer, also known as hepatocellular carcinoma, is steadily increasing. In the last twenty years, the number of cases has almost doubled...

Im Focus: Researchers at Fraunhofer monitor re-entry of Chinese space station Tiangong-1

In just a few weeks from now, the Chinese space station Tiangong-1 will re-enter the Earth's atmosphere where it will to a large extent burn up. It is possible that some debris will reach the Earth's surface. Tiangong-1 is orbiting the Earth uncontrolled at a speed of approx. 29,000 km/h.Currently the prognosis relating to the time of impact currently lies within a window of several days. The scientists at Fraunhofer FHR have already been monitoring Tiangong-1 for a number of weeks with their TIRA system, one of the most powerful space observation radars in the world, with a view to supporting the German Space Situational Awareness Center and the ESA with their re-entry forecasts.

Following the loss of radio contact with Tiangong-1 in 2016 and due to the low orbital height, it is now inevitable that the Chinese space station will...

Im Focus: Alliance „OLED Licht Forum“ – Key partner for OLED lighting solutions

Fraunhofer Institute for Organic Electronics, Electron Beam and Plasma Technology FEP, provider of research and development services for OLED lighting solutions, announces the founding of the “OLED Licht Forum” and presents latest OLED design and lighting solutions during light+building, from March 18th – 23rd, 2018 in Frankfurt a.M./Germany, at booth no. F91 in Hall 4.0.

They are united in their passion for OLED (organic light emitting diodes) lighting with all of its unique facets and application possibilities. Thus experts in...

Im Focus: Mars' oceans formed early, possibly aided by massive volcanic eruptions

Oceans formed before Tharsis and evolved together, shaping climate history of Mars

A new scenario seeking to explain how Mars' putative oceans came and went over the last 4 billion years implies that the oceans formed several hundred million...

Im Focus: Tiny implants for cells are functional in vivo

For the first time, an interdisciplinary team from the University of Basel has succeeded in integrating artificial organelles into the cells of live zebrafish embryos. This innovative approach using artificial organelles as cellular implants offers new potential in treating a range of diseases, as the authors report in an article published in Nature Communications.

In the cells of higher organisms, organelles such as the nucleus or mitochondria perform a range of complex functions necessary for life. In the networks of...

All Focus news of the innovation-report >>>



Industry & Economy
Event News

Virtual reality conference comes to Reutlingen

19.03.2018 | Event News

Ultrafast Wireless and Chip Design at the DATE Conference in Dresden

16.03.2018 | Event News

International Tinnitus Conference of the Tinnitus Research Initiative in Regensburg

13.03.2018 | Event News

Latest News

Custom sequences for polymers using visible light

22.03.2018 | Materials Sciences

Scientists develop tiny tooth-mounted sensors that can track what you eat

22.03.2018 | Health and Medicine

Mat baits, hooks and destroys pollutants in water

22.03.2018 | Earth Sciences

Science & Research
Overview of more VideoLinks >>>