Toward new classification criteria for juvenile idiopathic arthritis: First steps, pediatric rheumatology international trials organization international consensus

Alberto Martini, Angelo Ravelli, Tadej Avcin, Michael W. Beresford, Ruben Burgos-Vargas, Ruben Cuttica, Norman Todd Ilowite, Raju Khubchandani, Ronald M. Laxer, Daniel J. Lovell, Ross E. Petty, Carol A. Wallace, Nico M. Wulffraat, Angela Pistorio, Nicolino Ruperto

Research output: Contribution to journalArticle

23 Citations (Scopus)

Abstract

Objective. To revise the current juvenile idiopathic arthritis (JIA) International League of Associations for Rheumatology (ILAR) classification criteria with an evidence-based approach, using clinical and routine laboratory measures available worldwide, to identify homogeneous clinical groups and to distinguish those forms of chronic arthritis typically seen only in children from the childhood counterpart of adult diseases. Methods. The overall project consists of 4 steps. This work represents Step 1, a Delphi Web-based consensus and Step 2, an international nominal group technique (NGT) consensus conference for the new provisional Pediatric Rheumatology International Trials Organization JIA classification criteria. A future large data collection of at least 1000 new-onset JIA patients (Step 3) followed by analysis and NGT consensus (Step 4) will provide data for the evidence-based validation of the JIA classification criteria. Results. In Step 1, three Delphi rounds of interactions were implemented to revise the 7 ILAR JIA categories. In Step 2, forty-seven questions with electronic voting were implemented to derive the new proposed criteria. Four disorders were proposed: (a) systemic JIA; (b) rheumatoid factor-positive JIA; (c) enthesitis/spondylitis-related JIA; and (d) early-onset antinuclear antibody-positive JIA. The other forms were gathered under the term "others." These will be analyzed during the prospective data collection using a list of descriptors to see whether the clustering of some of them could identify homogeneous entities. Conclusion. An international consensus was reached to identify different proposed homogeneous chronic disorders that fall under the historical term JIA. These preliminary criteria will be formally validated with a dedicated project.

Original languageEnglish (US)
Pages (from-to)190-197
Number of pages8
JournalJournal of Rheumatology
Volume46
Issue number2
DOIs
StatePublished - Feb 1 2019

Fingerprint

Juvenile Arthritis
Rheumatology
Organizations
Pediatrics
Spondylitis
Rheumatoid Factor
Antinuclear Antibodies
Politics
Arthritis
Cluster Analysis

Keywords

  • antinuclear antibodies
  • autoimmune diseases
  • Juvenile idiopathic arthritis

ASJC Scopus subject areas

  • Rheumatology
  • Immunology and Allergy
  • Immunology

Cite this

Toward new classification criteria for juvenile idiopathic arthritis : First steps, pediatric rheumatology international trials organization international consensus. / Martini, Alberto; Ravelli, Angelo; Avcin, Tadej; Beresford, Michael W.; Burgos-Vargas, Ruben; Cuttica, Ruben; Ilowite, Norman Todd; Khubchandani, Raju; Laxer, Ronald M.; Lovell, Daniel J.; Petty, Ross E.; Wallace, Carol A.; Wulffraat, Nico M.; Pistorio, Angela; Ruperto, Nicolino.

In: Journal of Rheumatology, Vol. 46, No. 2, 01.02.2019, p. 190-197.

Research output: Contribution to journalArticle

Martini, A, Ravelli, A, Avcin, T, Beresford, MW, Burgos-Vargas, R, Cuttica, R, Ilowite, NT, Khubchandani, R, Laxer, RM, Lovell, DJ, Petty, RE, Wallace, CA, Wulffraat, NM, Pistorio, A & Ruperto, N 2019, 'Toward new classification criteria for juvenile idiopathic arthritis: First steps, pediatric rheumatology international trials organization international consensus', Journal of Rheumatology, vol. 46, no. 2, pp. 190-197. https://doi.org/10.3899/jrheum.180168
Martini, Alberto ; Ravelli, Angelo ; Avcin, Tadej ; Beresford, Michael W. ; Burgos-Vargas, Ruben ; Cuttica, Ruben ; Ilowite, Norman Todd ; Khubchandani, Raju ; Laxer, Ronald M. ; Lovell, Daniel J. ; Petty, Ross E. ; Wallace, Carol A. ; Wulffraat, Nico M. ; Pistorio, Angela ; Ruperto, Nicolino. / Toward new classification criteria for juvenile idiopathic arthritis : First steps, pediatric rheumatology international trials organization international consensus. In: Journal of Rheumatology. 2019 ; Vol. 46, No. 2. pp. 190-197.
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abstract = "Objective. To revise the current juvenile idiopathic arthritis (JIA) International League of Associations for Rheumatology (ILAR) classification criteria with an evidence-based approach, using clinical and routine laboratory measures available worldwide, to identify homogeneous clinical groups and to distinguish those forms of chronic arthritis typically seen only in children from the childhood counterpart of adult diseases. Methods. The overall project consists of 4 steps. This work represents Step 1, a Delphi Web-based consensus and Step 2, an international nominal group technique (NGT) consensus conference for the new provisional Pediatric Rheumatology International Trials Organization JIA classification criteria. A future large data collection of at least 1000 new-onset JIA patients (Step 3) followed by analysis and NGT consensus (Step 4) will provide data for the evidence-based validation of the JIA classification criteria. Results. In Step 1, three Delphi rounds of interactions were implemented to revise the 7 ILAR JIA categories. In Step 2, forty-seven questions with electronic voting were implemented to derive the new proposed criteria. Four disorders were proposed: (a) systemic JIA; (b) rheumatoid factor-positive JIA; (c) enthesitis/spondylitis-related JIA; and (d) early-onset antinuclear antibody-positive JIA. The other forms were gathered under the term {"}others.{"} These will be analyzed during the prospective data collection using a list of descriptors to see whether the clustering of some of them could identify homogeneous entities. Conclusion. An international consensus was reached to identify different proposed homogeneous chronic disorders that fall under the historical term JIA. These preliminary criteria will be formally validated with a dedicated project.",
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AU - Cuttica, Ruben

AU - Ilowite, Norman Todd

AU - Khubchandani, Raju

AU - Laxer, Ronald M.

AU - Lovell, Daniel J.

AU - Petty, Ross E.

AU - Wallace, Carol A.

AU - Wulffraat, Nico M.

AU - Pistorio, Angela

AU - Ruperto, Nicolino

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N2 - Objective. To revise the current juvenile idiopathic arthritis (JIA) International League of Associations for Rheumatology (ILAR) classification criteria with an evidence-based approach, using clinical and routine laboratory measures available worldwide, to identify homogeneous clinical groups and to distinguish those forms of chronic arthritis typically seen only in children from the childhood counterpart of adult diseases. Methods. The overall project consists of 4 steps. This work represents Step 1, a Delphi Web-based consensus and Step 2, an international nominal group technique (NGT) consensus conference for the new provisional Pediatric Rheumatology International Trials Organization JIA classification criteria. A future large data collection of at least 1000 new-onset JIA patients (Step 3) followed by analysis and NGT consensus (Step 4) will provide data for the evidence-based validation of the JIA classification criteria. Results. In Step 1, three Delphi rounds of interactions were implemented to revise the 7 ILAR JIA categories. In Step 2, forty-seven questions with electronic voting were implemented to derive the new proposed criteria. Four disorders were proposed: (a) systemic JIA; (b) rheumatoid factor-positive JIA; (c) enthesitis/spondylitis-related JIA; and (d) early-onset antinuclear antibody-positive JIA. The other forms were gathered under the term "others." These will be analyzed during the prospective data collection using a list of descriptors to see whether the clustering of some of them could identify homogeneous entities. Conclusion. An international consensus was reached to identify different proposed homogeneous chronic disorders that fall under the historical term JIA. These preliminary criteria will be formally validated with a dedicated project.

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