2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and Systemic Juvenile Idiopathic Arthritis
Objective To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and disc...
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| Published in | Arthritis care & research (2010) Vol. 74; no. 4; pp. 521 - 537 |
|---|---|
| Main Authors | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
| Format | Journal Article |
| Language | English |
| Published |
Boston, USA
Wiley Periodicals, Inc
01.04.2022
Wiley Subscription Services, Inc |
| Subjects | |
| Online Access | Get full text |
| ISSN | 2151-464X 2151-4658 2151-4658 |
| DOI | 10.1002/acr.24853 |
Cover
| Abstract | Objective
To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided.
Methods
We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.
Results
Similar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional.
Conclusion
This clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision‐making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision‐making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver. |
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| AbstractList | ObjectiveTo provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided.MethodsWe developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.ResultsSimilar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional.ConclusionThis clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision‐making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision‐making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver. To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided.OBJECTIVETo provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided.We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.METHODSWe developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations.Similar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional.RESULTSSimilar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional.This clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision-making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision-making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver.CONCLUSIONThis clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision-making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision-making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver. Objective To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided. Methods We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. Results Similar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional. Conclusion This clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision‐making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision‐making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver. To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular joint (TMJ) arthritis, and systemic JIA with and without macrophage activation syndrome. Recommendations regarding tapering and discontinuing treatment in inactive systemic JIA are also provided. We developed clinically relevant Patient/Population, Intervention, Comparison, and Outcomes questions. After conducting a systematic literature review, the Grading of Recommendations Assessment, Development and Evaluation approach was used to rate the quality of evidence (high, moderate, low, or very low). A Voting Panel including clinicians and patients/caregivers achieved consensus on the direction (for or against) and strength (strong or conditional) of recommendations. Similar to those published in 2019, these JIA recommendations are based on clinical phenotypes of JIA, rather than a specific classification schema. This guideline provides recommendations for initial and subsequent treatment of JIA with oligoarthritis, TMJ arthritis, and systemic JIA as well as for tapering and discontinuing treatment in subjects with inactive systemic JIA. Other aspects of disease management, including factors that influence treatment choice and medication tapering, are discussed. Evidence for all recommendations was graded as low or very low in quality. For that reason, more than half of the recommendations are conditional. This clinical practice guideline complements the 2019 American College of Rheumatology JIA and uveitis guidelines, which addressed polyarthritis, sacroiliitis, enthesitis, and uveitis. It serves as a tool to support clinicians, patients, and caregivers in decision-making. The recommendations take into consideration the severity of both articular and nonarticular manifestations as well as patient quality of life. Although evidence is generally low quality and many recommendations are conditional, the inclusion of caregivers and patients in the decision-making process strengthens the relevance and applicability of the guideline. It is important to remember that these are recommendations. Clinical decisions, as always, should be made by the treating clinician and patient/caregiver. |
| Author | Cooper, Ashley M. Cron, Randy Q. Veiga, Keila Nigrovic, Peter A. Reston, James T. Horton, Daniel B. Gewanter, Harry Kimura, Yukiko Cuello, Carlos A. Klein‐Gitelman, Marisa Szymanski, Ann Marie Guzman, Jaime Rabinovich, C. Egla Turner, Amy S. Edelheit, Barbara Hays, Kimberly Sullivan, Nancy Mannion, Melissa L. Onel, Karen B. Feldman, Brian M. Barbar‐Smiley, Fatima Becker, Mara L. Shenoi, Susan Tesher, Melissa Murphy, Katherine Twilt, Marinka Trachtman, Rebecca Ombrello, Michael J. Turgunbaev, Marat Flanagan, Elaine Ferguson, Polly J. Peterson, Rosemary Angeles‐Han, Sheila T. Gillispie‐Taylor, Miriah Lee, Tzielan Saad, Nadine Lovell, Daniel J. |
| AuthorAffiliation | 8 The Hospital for Sick Children, Toronto, Ontario, Canada 26 Emory University, Atlanta, Georgia 27 University of Michigan, Ann Arbor 9 University of Iowa Carver College of Medicine, Iowa City 10 Children’s Hospital of Richmond at VCU, Richmond, Virginia 25 Dell Children’s Medical Center, Austin, Texas 31 Amy S. Turner: American College of Rheumatology, Atlanta, Georgia 23 Baylor College of Medicine, Houston, Texas 11 BC Children’s Hospital, Vancouver, British Columbia, Canada 15 Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, Massachusetts 30 Icahn School of Medicine at Mount Sinai, New York, New York 28 ECRI Institute, Plymouth Meeting, Pennsylvania 7 University of Alabama at Birmingham 24 Penn State Health Children’s Hospital, Hershey, Pennsylvania 29 Johns Hopkins All Children’s Hospital, St. Petersburg, Florida 22 Connecticut Children’s Medical Center, Hartford 13 Stanford University, Palo Alto, California 2 Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey |
| AuthorAffiliation_xml | – name: 7 University of Alabama at Birmingham – name: 8 The Hospital for Sick Children, Toronto, Ontario, Canada – name: 23 Baylor College of Medicine, Houston, Texas – name: 5 McMaster University, Hamilton, Ontario, Canada – name: 10 Children’s Hospital of Richmond at VCU, Richmond, Virginia – name: 30 Icahn School of Medicine at Mount Sinai, New York, New York – name: 18 University of Calgary and Alberta Children’s Hospital, Calgary, Alberta, Canada – name: 6 Duke University, Durham, North Carolina – name: 4 Seattle Children’s Hospital and Research Center and University of Washington, Seat tle – name: 14 Louisiana Department of Health, New Orleans – name: 24 Penn State Health Children’s Hospital, Hershey, Pennsylvania – name: 25 Dell Children’s Medical Center, Austin, Texas – name: 13 Stanford University, Palo Alto, California – name: 17 University of Chicago, Chicago, Illinois – name: 32 Maria Fareri Children’s Hospital, Valhalla, New York – name: 11 BC Children’s Hospital, Vancouver, British Columbia, Canada – name: 26 Emory University, Atlanta, Georgia – name: 29 Johns Hopkins All Children’s Hospital, St. Petersburg, Florida – name: 19 Ann & Robert Lurie Children’s Hospital of Chicago and Northwestern University, Chicago, Illinois – name: 27 University of Michigan, Ann Arbor – name: 12 Hackensack Meridian School of Medicine, Hackensack, New Jersey – name: 2 Rutgers Robert Wood Johnson Medical School, New Brunswick, New Jersey – name: 16 NIH, Bethesda, Maryland – name: 9 University of Iowa Carver College of Medicine, Iowa City – name: 15 Boston Children’s Hospital and Brigham and Women’s Hospital, Boston, Massachusetts – name: 1 Hospital for Special Surgery, New York, New York – name: 28 ECRI Institute, Plymouth Meeting, Pennsylvania – name: 31 Amy S. Turner: American College of Rheumatology, Atlanta, Georgia – name: 3 Cincinnati Children’s Hospital Medical Center and University of Cincinnati, Cincinnati, Ohio – name: 20 Nationwide Children’s Hospital, Columbus, Ohio – name: 22 Connecticut Children’s Medical Center, Hartford – name: 21 Children’s Mercy Hospital, Kansas City, Missouri |
| Author_xml | – sequence: 1 givenname: Karen B. orcidid: 0000-0002-1238-5361 surname: Onel fullname: Onel, Karen B. email: onelk@hss.edu organization: Hospital for Special Surgery – sequence: 2 givenname: Daniel B. orcidid: 0000-0002-1831-1339 surname: Horton fullname: Horton, Daniel B. organization: Rutgers Robert Wood Johnson Medical School – sequence: 3 givenname: Daniel J. orcidid: 0000-0003-1604-0130 surname: Lovell fullname: Lovell, Daniel J. organization: Cincinnati Children's Hospital Medical Center and University of Cincinnati – sequence: 4 givenname: Susan orcidid: 0000-0002-2495-594X surname: Shenoi fullname: Shenoi, Susan organization: Seattle Children's Hospital and Research Center and University of Washington – sequence: 5 givenname: Carlos A. surname: Cuello fullname: Cuello, Carlos A. organization: McMaster University – sequence: 6 givenname: Sheila T. orcidid: 0000-0002-9552-6464 surname: Angeles‐Han fullname: Angeles‐Han, Sheila T. organization: Cincinnati Children's Hospital Medical Center and University of Cincinnati – sequence: 7 givenname: Mara L. surname: Becker fullname: Becker, Mara L. organization: Duke University – sequence: 8 givenname: Randy Q. orcidid: 0000-0003-2661-3086 surname: Cron fullname: Cron, Randy Q. organization: University of Alabama at Birmingham – sequence: 9 givenname: Brian M. surname: Feldman fullname: Feldman, Brian M. organization: The Hospital for Sick Children – sequence: 10 givenname: Polly J. surname: Ferguson fullname: Ferguson, Polly J. organization: University of Iowa Carver College of Medicine – sequence: 11 givenname: Harry surname: Gewanter fullname: Gewanter, Harry organization: Children's Hospital of Richmond at VCU – sequence: 12 givenname: Jaime orcidid: 0000-0001-8977-2581 surname: Guzman fullname: Guzman, Jaime organization: BC Children's Hospital – sequence: 13 givenname: Yukiko orcidid: 0000-0001-7132-3390 surname: Kimura fullname: Kimura, Yukiko organization: Hackensack Meridian School of Medicine – sequence: 14 givenname: Tzielan surname: Lee fullname: Lee, Tzielan organization: Stanford University – sequence: 15 givenname: Katherine surname: Murphy fullname: Murphy, Katherine organization: Louisiana Department of Health – sequence: 16 givenname: Peter A. surname: Nigrovic fullname: Nigrovic, Peter A. organization: Boston Children's Hospital and Brigham and Women's Hospital – sequence: 17 givenname: Michael J. orcidid: 0000-0003-3322-4089 surname: Ombrello fullname: Ombrello, Michael J. organization: NIH – sequence: 18 givenname: C. Egla surname: Rabinovich fullname: Rabinovich, C. Egla organization: Duke University – sequence: 19 givenname: Melissa orcidid: 0000-0002-6322-1375 surname: Tesher fullname: Tesher, Melissa organization: University of Chicago – sequence: 20 givenname: Marinka surname: Twilt fullname: Twilt, Marinka organization: University of Calgary and Alberta Children's Hospital – sequence: 21 givenname: Marisa surname: Klein‐Gitelman fullname: Klein‐Gitelman, Marisa organization: Ann & Robert Lurie Children's Hospital of Chicago and Northwestern University – sequence: 22 givenname: Fatima orcidid: 0000-0001-8508-3578 surname: Barbar‐Smiley fullname: Barbar‐Smiley, Fatima organization: Nationwide Children's Hospital – sequence: 23 givenname: Ashley M. orcidid: 0000-0002-8855-845X surname: Cooper fullname: Cooper, Ashley M. organization: Children's Mercy Hospital – sequence: 24 givenname: Barbara surname: Edelheit fullname: Edelheit, Barbara organization: Connecticut Children's Medical Center – sequence: 25 givenname: Miriah surname: Gillispie‐Taylor fullname: Gillispie‐Taylor, Miriah organization: Baylor College of Medicine – sequence: 26 givenname: Kimberly surname: Hays fullname: Hays, Kimberly organization: Penn State Health Children's Hospital – sequence: 27 givenname: Melissa L. orcidid: 0000-0002-2216-970X surname: Mannion fullname: Mannion, Melissa L. organization: University of Alabama at Birmingham – sequence: 28 givenname: Rosemary orcidid: 0000-0002-0959-2343 surname: Peterson fullname: Peterson, Rosemary organization: Dell Children's Medical Center – sequence: 29 givenname: Elaine surname: Flanagan fullname: Flanagan, Elaine organization: Emory University – sequence: 30 givenname: Nadine surname: Saad fullname: Saad, Nadine organization: University of Michigan – sequence: 31 givenname: Nancy surname: Sullivan fullname: Sullivan, Nancy organization: Plymouth Meeting – sequence: 32 givenname: Ann Marie surname: Szymanski fullname: Szymanski, Ann Marie organization: Johns Hopkins All Children's Hospital – sequence: 33 givenname: Rebecca orcidid: 0000-0002-8634-9443 surname: Trachtman fullname: Trachtman, Rebecca organization: Icahn School of Medicine at Mount Sinai – sequence: 34 givenname: Marat surname: Turgunbaev fullname: Turgunbaev, Marat organization: American College of Rheumatology – sequence: 35 givenname: Keila surname: Veiga fullname: Veiga, Keila organization: Maria Fareri Children's Hospital – sequence: 36 givenname: Amy S. orcidid: 0000-0001-7695-2022 surname: Turner fullname: Turner, Amy S. organization: American College of Rheumatology – sequence: 37 givenname: James T. surname: Reston fullname: Reston, James T. organization: Plymouth Meeting |
| BackLink | https://www.ncbi.nlm.nih.gov/pubmed/35233986$$D View this record in MEDLINE/PubMed |
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| Notes | This article is published simultaneously in Supported by the American College of Rheumatology. Dr. Horton's work was supported by the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH (grant K23‐AR‐070286). Dr. Ombrello's work was supported by the Intramural Research Program of the National Institute of Arthritis and Musculoskeletal and Skin Diseases, NIH (grant AR‐041198). Arthritis & Rheumatology . https://onlinelibrary.wiley.com/action/downloadSupplement?doi=10.1002%2Facr.24853&file=acr.24853‐sup‐0001‐Disclosureform.pdf Author disclosures are available at ObjectType-Article-1 SourceType-Scholarly Journals-1 ObjectType-Feature-2 content type line 14 content type line 23 ObjectType-Undefined-3 Study conception and design. Onel, Horton, Lovell, Shenoi, Cuello, Lee, Murphy, Barbar-Smiley, Edelheit, Sullivan, Turner. Analysis and interpretation of data. Onel, Horton, Lovell, Shenoi, Cuello, Angeles-Han, Becker, Cron, Feldman, Ferguson, Gewanter, Guzman, Kimura, Nigrovic, Ombrello, Rabinovich, Tesher, Twilt, Klein-Gitelman, Cooper, Edelheit, Gillispie-Taylor, Mannion, Sullivan, Szymanski, Trachtman, Turgunbaev, Veiga, Reston. AUTHOR CONTRIBUTIONS All authors were involved in drafting the article or revising it critically for important intellectual content, and all authors approved the final version to be published. Dr. Onel had full access to all of the data in the study and takes responsibility for the integrity of the data and the accuracy of the data analysis. Acquisition of data. Onel, Horton, Lovell, Shenoi, Kimura, Lee, Murphy, Nigrovic, Ombrello, Rabinovich, Twilt, Barbar-Smiley, Cooper, Edelheit, Gillispie-Taylor, Hays, Mannion, Peterson, Flanagan, Saad, Sullivan, Szymanski, Trachtman, Reston. |
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| OpenAccessLink | https://hdl.handle.net/2027.42/172074 |
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| PublicationDate | April 2022 |
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| PublicationPlace | Boston, USA |
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| PublicationTitle | Arthritis care & research (2010) |
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To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis,... To provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis, temporomandibular... ObjectiveTo provide updated guidelines for pharmacologic management of juvenile idiopathic arthritis (JIA), focusing on treatment of oligoarthritis,... |
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| SubjectTerms | Antirheumatic Agents - therapeutic use Arthritis Arthritis, Juvenile - diagnosis Arthritis, Juvenile - drug therapy Caregivers Cell activation Decision making Glucocorticoids - therapeutic use Humans Literature reviews Macrophages Patients Phenotypes Polyarthritis Quality of Life Rheumatology Sacroiliitis Temporomandibular Joint Temporomandibular Joint Disorders - diagnosis Temporomandibular Joint Disorders - drug therapy United States Uveitis Uveitis - drug therapy |
| Title | 2021 American College of Rheumatology Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Oligoarthritis, Temporomandibular Joint Arthritis, and Systemic Juvenile Idiopathic Arthritis |
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