Evidence map›Paper›PMID 29643108›Full record

ArticleAnnals of the rheumatic diseases2018

Treating juvenile idiopathic arthritis to target: recommendations of an international task force.

Angelo Ravelli, Alessandro Consolaro, Gerd Horneff, Ronald M Laxer, Daniel J Lovell, Nico M Wulffraat, Jonathan D Akikusa, Sulaiman M Al-Mayouf, Jordi Antón, Tadej Avcin and 21 more

Registry-linked trialAbstract readConsensus Statement
PubMed Publisher
In one paragraph

Article in Annals of the rheumatic diseases, 2018. The graph could read no effect estimate from its abstract, so it casts no vote on the map. It is linked to trial NCT03728478 (Comparison of STep-up and Step-down Therapeutic Strategies in Childhood ARthritiS), which is not on this map. Cited by 189 papers, 12 of them syntheses that pooled it.

0numbers the graph read from it
0cells of the map it votes in
189citing papers in PubMed, 12 pooled it
–field-weighted citation impact
1 · What the graph read from it

What it found

Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.

The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.

2 · The registry

The trial behind it

Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.

NCT03728478 phase3recruitingnot on this mapstarted 2019, after this paper: background citation

Comparison of STep-up and Step-down Therapeutic Strategies in Childhood ARthritiS

TypeinterventionalSponsorIstituto Giannina GasliniRan2019 to 2025Enrolled260ConditionsOligoarthritis, Juvenile, Polyarthritis, Juvenile, Rheumatoid Factor NegativeArmsEtanercept, Methotrexate, Intra-articular corticosteroid injections
3 · Its place in the literature

Who cites it

189 citing papers in PubMed, 12 syntheses or guidelines pooled it.

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  5. Methotrexate for juvenile idiopathic arthritis.The Cochrane database of systematic reviews · 2024
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129 more citing papers are in PubMed but not listed here.

4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

31 authors.

Angelo RavelliClinica Pediatrica e Reumatologia, Università degli Studi di Genova and Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina, Genoa, Italy.
Alessandro ConsolaroClinica Pediatrica e Reumatologia, Università degli Studi di Genova and Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina, Genoa, Italy.
Gerd HorneffDepartment of Pediatrics, Asklepios Klinik Sankt Augustin, Sankt Augustin, Germany.
Ronald M LaxerDivision od Rheumatology, University of Toronto and The Hospital for Sick Children, Toronto, Ontario, Canada.
Daniel J LovellDivision of Rheumatology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Nico M WulffraatDepartment of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht and University of Utrecht, Utrecht, The Netherlands.
Jonathan D AkikusaRheumatology Unit, Department of General Medicine, The Royal Children's Hospital and Murdoch Children's Research Institute, Melbourne, Victoria, Australia.
Sulaiman M Al-MayoufDepartment of Pediatric Rheumatology, King Faisal Specialist Hospital and Research Center and Alfaisal University, Riyadh, Saudi Arabia.
Jordi AntónDivision of Pediatric Rheumatology, Hospital Sant Joan de Déu, Universitat de Barcelona, Barcelona, Spain.
Tadej AvcinDepartment of Allergology, Rheumatology and Clinical Immunology, University Medical Center Ljubljana and Medical Faculty, University of Ljubljana, Ljubljana, Slovenia.
Roberta A BerardDivision of Rheumatology, Western University Children's Hospital, London Health Sciences Centre, London, Ontario, Canada.
Michael W BeresfordInstitute of Translational Medicine, University of Liverpool and Alder Hey Children's NHS Foundation Trust, Liverpool, UK.ORCID 0000-0002-5400-9911
Ruben Burgos-VargasRheumatology Department, Hospital General de México Eduardo Liceaga, México City, Mexico.
Rolando CimazPediatric Rheumatology, Azienda Ospedaliero Universitaria Meyer, Florence, Italy.
Fabrizio De BenedettiDivision of Rheumatology, Istituto di Ricovero e Cura a Carattere Scientifico Ospedale Pediatrico Bambino Gesù, Rome, Italy.
Erkan DemirkayaDivision of Rheumatology, Western University Children's Hospital, London Health Sciences Centre, London, Ontario, Canada.
Dirk FoellPediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany.
Yasuhiko ItohDepartment of Pediatrics, Nippon Medical School, Bunkyo City, Japan.
Pekka LahdenneInstitute of Clinical Medicine, Children's Hospital, Helsinki University Hospital, Helsinki, Finland.
Esi M MorganDivision of Rheumatology, Cincinnati Children's Hospital Medical Center, University of Cincinnati, Cincinnati, Ohio, USA.
Pierre QuartierParis-Descartes University, IMAGINE Institute, RAISE 22 National Reference Centre, Necker-Enfants Malades Hospital, Assistance Publique Hopitaux de Paris, Paris, France.
Nicolino RupertoClinica Pediatrica e Reumatologia, Istituto di Ricovero e Cura a Carattere Scientifico Istituto Giannina Gaslini, Genoa, Italy.
Ricardo RussoServicio de Inmunología y Reumatología, Hospital de Pediatría Garrahan, Buenos Aires, Argentina.
Claudia Saad-MagalhãesReumatologia Pediátrica, São Paulo State University (UNESP), Botucatu, Brazil.
Sujata SawhneyDepartment of Rheumatology, ISIC Superspeciality Hospital and Sir Ganga Ram Hospital, New Delhi, India.
Christiaan ScottRed Cross War Memorial Children's Hospital, University of Cape Town, Cape Town, South Africa.
Susan ShenoiPediatric Rheumatology, Seattle Children's Hospital and Research Center, University of Washington, Seattle, Washington, USA.
Joost F SwartDepartment of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht and University of Utrecht, Utrecht, The Netherlands.
Yosef UzielPediatric Rheumatology Unit, Department of Pediatrics, Meir Medical Center, Kfar-Saba, Israel.
Sebastiaan J VastertDepartment of Paediatric Immunology, Wilhelmina Children's Hospital, University Medical Center Utrecht and University of Utrecht, Utrecht, The Netherlands.
Josef S SmolenDivision of Rheumatology, Department of Medicine3, Medical University of Vienna, Vienna, Austria.

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

Recent therapeutic advances in juvenile idiopathic arthritis (JIA) have made remission an achievable goal for most patients. Reaching this target leads to improved outcomes. The objective was to develop recommendations for treating JIA to target. A Steering Committee formulated a set of recommendations based on evidence derived from a systematic literature review. These were subsequently discussed, amended and voted on by an international Task Force of 30 paediatric rheumatologists in a consensus-based, Delphi-like procedure. Although the literature review did not reveal trials that compared a treat-to-target approach with another or no strategy, it provided indirect evidence regarding an optimised approach to therapy that facilitated development of recommendations. The group agreed on six overarching principles and eight recommendations. The main treatment target, which should be based on a shared decision with parents/patients, was defined as remission, with the alternative target of low disease activity. The frequency and timeline of follow-up evaluations to ensure achievement and maintenance of the target depend on JIA category and level of disease activity. Additional recommendations emphasise the importance of ensuring adequate growth and development and avoiding long-term systemic glucocorticoid administration to maintain the target. All items were agreed on by more than 80% of the members of the Task Force. A research agenda was formulated. The Task Force developed recommendations for treating JIA to target, being aware that the evidence is not strong and needs to be expanded by future research. These recommendations can inform various stakeholders about strategies to reach optimal outcomes for JIA.

Indexed as

Advisory CommitteesAntirheumatic AgentsArthritis, JuvenileDisease ManagementEvidence-Based MedicineHumansRemission InductionSeverity of Illness IndexAntirheumatic Agentsjuvenile idiopathic arthritisoutcomes researchtreatment

Identifiers

PMID29643108

What OpenQuestion holds

Textmetadata
Read underepoch 390

Registered trials

Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.