Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis

Esi Morgan Dewitt, Yukiko Kimura, Timothy Beukelman, Peter A. Nigrovic, Karen Onel, Sampath Prahalad, Rayfel Schneider, Matthew L. Stoll, Sheila Angeles-Han, Diana Milojevic, Kenneth N. Schikler, Richard K. Vehe, Jennifer E. Weiss, Pamela Weiss, Norman Todd Ilowite, Carol A. Wallace

Research output: Contribution to journalArticle

115 Citations (Scopus)

Abstract

Objective. There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (JIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of systemic JIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies. Methods. Case-based surveys were administered to CARRA members to identify prevailing treatments for new-onset systemic JIA. A 2-day consensus conference in April 2010 employed modified nominal group technique to formulate preliminary treatment plans and determine important data elements for collection. Followup surveys were employed to refine the plans and assess clinical acceptability. Results. The initial case-based survey identified significant variability among current treatment approaches for new-onset systemic JIA, underscoring the utility of standardized plans to evaluate comparative effectiveness. We developed 4 consensus treatment plans for the first 9 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The 4 treatment regimens included glucocorticoids only, or therapy with methotrexate, anakinra, or tocilizumab, with or without glucocorticoids. This approach was approved by >78% of the CARRA membership. Conclusion. Four standardized treatment plans were developed for new-onset systemic JIA. Coupled with data collection at defined intervals, use of these treatment plans will create the opportunity to evaluate comparative effectiveness in an observational setting to optimize initial management of systemic JIA.

Original languageEnglish (US)
Pages (from-to)1001-1010
Number of pages10
JournalArthritis Care and Research
Volume64
Issue number7
DOIs
StatePublished - Jul 2012

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Juvenile Arthritis
Therapeutics
Rheumatology
Arthritis
Glucocorticoids
Appointments and Schedules
Research
Interleukin 1 Receptor Antagonist Protein
Methotrexate

ASJC Scopus subject areas

  • Rheumatology

Cite this

Dewitt, E. M., Kimura, Y., Beukelman, T., Nigrovic, P. A., Onel, K., Prahalad, S., ... Wallace, C. A. (2012). Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis. Arthritis Care and Research, 64(7), 1001-1010. https://doi.org/10.1002/acr.21625

Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis. / Dewitt, Esi Morgan; Kimura, Yukiko; Beukelman, Timothy; Nigrovic, Peter A.; Onel, Karen; Prahalad, Sampath; Schneider, Rayfel; Stoll, Matthew L.; Angeles-Han, Sheila; Milojevic, Diana; Schikler, Kenneth N.; Vehe, Richard K.; Weiss, Jennifer E.; Weiss, Pamela; Ilowite, Norman Todd; Wallace, Carol A.

In: Arthritis Care and Research, Vol. 64, No. 7, 07.2012, p. 1001-1010.

Research output: Contribution to journalArticle

Dewitt, EM, Kimura, Y, Beukelman, T, Nigrovic, PA, Onel, K, Prahalad, S, Schneider, R, Stoll, ML, Angeles-Han, S, Milojevic, D, Schikler, KN, Vehe, RK, Weiss, JE, Weiss, P, Ilowite, NT & Wallace, CA 2012, 'Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis', Arthritis Care and Research, vol. 64, no. 7, pp. 1001-1010. https://doi.org/10.1002/acr.21625
Dewitt EM, Kimura Y, Beukelman T, Nigrovic PA, Onel K, Prahalad S et al. Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis. Arthritis Care and Research. 2012 Jul;64(7):1001-1010. https://doi.org/10.1002/acr.21625
Dewitt, Esi Morgan ; Kimura, Yukiko ; Beukelman, Timothy ; Nigrovic, Peter A. ; Onel, Karen ; Prahalad, Sampath ; Schneider, Rayfel ; Stoll, Matthew L. ; Angeles-Han, Sheila ; Milojevic, Diana ; Schikler, Kenneth N. ; Vehe, Richard K. ; Weiss, Jennifer E. ; Weiss, Pamela ; Ilowite, Norman Todd ; Wallace, Carol A. / Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis. In: Arthritis Care and Research. 2012 ; Vol. 64, No. 7. pp. 1001-1010.
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abstract = "Objective. There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (JIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of systemic JIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies. Methods. Case-based surveys were administered to CARRA members to identify prevailing treatments for new-onset systemic JIA. A 2-day consensus conference in April 2010 employed modified nominal group technique to formulate preliminary treatment plans and determine important data elements for collection. Followup surveys were employed to refine the plans and assess clinical acceptability. Results. The initial case-based survey identified significant variability among current treatment approaches for new-onset systemic JIA, underscoring the utility of standardized plans to evaluate comparative effectiveness. We developed 4 consensus treatment plans for the first 9 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The 4 treatment regimens included glucocorticoids only, or therapy with methotrexate, anakinra, or tocilizumab, with or without glucocorticoids. This approach was approved by >78{\%} of the CARRA membership. Conclusion. Four standardized treatment plans were developed for new-onset systemic JIA. Coupled with data collection at defined intervals, use of these treatment plans will create the opportunity to evaluate comparative effectiveness in an observational setting to optimize initial management of systemic JIA.",
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AU - Kimura, Yukiko

AU - Beukelman, Timothy

AU - Nigrovic, Peter A.

AU - Onel, Karen

AU - Prahalad, Sampath

AU - Schneider, Rayfel

AU - Stoll, Matthew L.

AU - Angeles-Han, Sheila

AU - Milojevic, Diana

AU - Schikler, Kenneth N.

AU - Vehe, Richard K.

AU - Weiss, Jennifer E.

AU - Weiss, Pamela

AU - Ilowite, Norman Todd

AU - Wallace, Carol A.

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N2 - Objective. There is wide variation in therapeutic approaches to systemic juvenile idiopathic arthritis (JIA) among North American rheumatologists. Understanding the comparative effectiveness of the diverse therapeutic options available for treatment of systemic JIA can result in better health outcomes. The Childhood Arthritis and Rheumatology Research Alliance (CARRA) developed consensus treatment plans and standardized assessment schedules for use in clinical practice to facilitate such studies. Methods. Case-based surveys were administered to CARRA members to identify prevailing treatments for new-onset systemic JIA. A 2-day consensus conference in April 2010 employed modified nominal group technique to formulate preliminary treatment plans and determine important data elements for collection. Followup surveys were employed to refine the plans and assess clinical acceptability. Results. The initial case-based survey identified significant variability among current treatment approaches for new-onset systemic JIA, underscoring the utility of standardized plans to evaluate comparative effectiveness. We developed 4 consensus treatment plans for the first 9 months of therapy, as well as case definitions and clinical and laboratory monitoring schedules. The 4 treatment regimens included glucocorticoids only, or therapy with methotrexate, anakinra, or tocilizumab, with or without glucocorticoids. This approach was approved by >78% of the CARRA membership. Conclusion. Four standardized treatment plans were developed for new-onset systemic JIA. Coupled with data collection at defined intervals, use of these treatment plans will create the opportunity to evaluate comparative effectiveness in an observational setting to optimize initial management of systemic JIA.

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