@article{0d79d5698502400ea961658e2262e33f,
title = "2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis",
abstract = "Objective: To develop recommendations for the screening, monitoring, and treatment of uveitis in children with juvenile idiopathic arthritis (JIA). Methods: Pediatric rheumatologists, ophthalmologists with expertise in uveitis, patient representatives, and methodologists generated key clinical questions to be addressed by this guideline. This was followed by a systematic literature review and rating of the available evidence according to the GRADE (Grading of Recommendations Assessment, Development and Evaluation) methodology. A group consensus process was used to compose the final recommendations and grade their strength as conditional or strong. Results: Due to a lack of literature with good quality of evidence, recommendations were formulated on the basis of available evidence and a consensus expert opinion. Regular ophthalmic screening of children with JIA is recommended because of the risk of uveitis, and the frequency of screening should be based on individual risk factors. Regular ophthalmic monitoring of children with uveitis is recommended, and intervals should be based on ocular examination findings and treatment regimen. Ophthalmic monitoring recommendations were strong primarily because of concerns of vision-threatening complications of uveitis with infrequent monitoring. Topical glucocorticoids should be used as initial treatment to achieve control of inflammation. Methotrexate and the monoclonal antibody tumor necrosis factor inhibitors adalimumab and infliximab are recommended when systemic treatment is needed for the management of uveitis. The timely addition of nonbiologic and biologic drugs is recommended to maintain uveitis control in children who are at continued risk of vision loss. Conclusion: This guideline provides direction for clinicians and patients/parents making decisions on the screening, monitoring, and management of children with JIA and uveitis, using GRADE methodology and informed by a consensus process with input from rheumatology and ophthalmology experts, current literature, and patient/parent preferences and values.",
author = "Angeles-Han, {Sheila T.} and Sarah Ringold and Timothy Beukelman and Daniel Lovell and Cuello, {Carlos A.} and Becker, {Mara L.} and Colbert, {Robert A.} and Feldman, {Brian M.} and Holland, {Gary N.} and Ferguson, {Polly J.} and Harry Gewanter and Jaime Guzman and Jennifer Horonjeff and Nigrovic, {Peter A.} and Ombrello, {Michael J.} and Passo, {Murray H.} and Stoll, {Matthew L.} and Rabinovich, {C. Egla} and Sen, {H. Nida} and Rayfel Schneider and Olha Halyabar and Kimberly Hays and Shah, {Amit Aakash} and Nancy Sullivan and Szymanski, {Ann Marie} and Marat Turgunbaev and Amy Turner and James Reston",
note = "Funding Information: Supported by the American College of Rheumatology and the Arthritis Foundation. Dr. Angeles-Han{\textquoteright}s work was supported by the N 阀H (grant K23-EY-021760 from the National Eye 阀nstitute), the Rheumatology Research Foundation, and the Cincinnati Children{\textquoteright}s Hospital Medical Center Research 阀nnovation and Pilot fund. Drs. Colbert and Ombrello{\textquoteright}s work was supported by the N 阀H (grants AR-041184 and AR-041198, respectively, from the 阀ntramural Research Program of the National 阀nstitute of Arthritis and Musculoskeletal and Skin Diseases). Dr. Ferguson{\textquoteright}s work was supported by the N 阀H (grant AR-059-703). Dr. Nigrovic{\textquoteright}s work was supported by the Fundaci{\'o}n Bechara. Dr. Sen{\textquoteright}s work was supported by the 阀ntramural Research Program of the National Eye 阀nstitute, N 阀H (grant EY-000356-16). Funding Information: Dr. Beukelman has received consulting fees from Bristol-Myers Squibb, Sobi, UCB, and Novartis (less than $10,000 each). Dr. Lovell has received consulting fees from AstraZeneca, Amgen, Abbott, Wyeth Pharmaceuticals, Pfizer, Ho 贀mann-La Roche, Novartis, UCB, Takeda, Janssen, GlaxoSmithKline, Boehringer 阀ngelheim, Celgene, Bristol-Myers Squibb, and AbbVie (less than $10,000 each). Dr. Nigrovic has received consulting fees from Bristol-Myers Squibb, Pfizer, AbbVie, Novartis, and Sobi (less than $10,000 each) and research grants from Sobi, Novartis, AbbVie, and Genentech (support of the FROST study of systemic J 阀A through CARRA). Dr. Stoll has received speaking fees from Novartis (less than $10,000). Dr. Rabinovich has received consulting fees from AbbVie (less than $10,000). Dr. Schneider has received consulting fees from Novartis and Sobi (less than $10,000 each). No other disclosures relevant to this article were reported.",
year = "2019",
month = jun,
doi = "10.1002/art.40885",
language = "English (US)",
volume = "71",
pages = "864--877",
journal = "Arthritis and Rheumatology",
issn = "2326-5191",
publisher = "John Wiley and Sons Ltd",
number = "6",
}