Overview
Polyarticular juvenile idiopathic arthritis (JIA) is a chronic inflammatory condition characterized by arthritis affecting five or more joints in children under 16 years of age, often accompanied by systemic features like fever and rash 1.Diagnosis
Presence of arthritis in five or more joints 1.
Exclusion of other rheumatologic conditions through clinical evaluation and laboratory tests 1.
Elevated inflammatory markers such as ESR and CRP may be observed 1.
Imaging studies like X-rays may show early joint damage in chronic cases 1.Management
First-line treatments: Nonsteroidal anti-inflammatory drugs (NSAIDs) for pain and inflammation 1.
Disease-modifying antirheumatic drugs (DMARDs): Methotrexate is commonly used as first-line biologic DMARD 1.
Biologics: TNF inhibitors (e.g., etanercept, adalimumab) or other biologic agents like IL-6 inhibitors (e.g., tocilizumab) for refractory cases 1.
Physical therapy: Essential for maintaining joint function and mobility 1.
Regular monitoring: Frequent assessments of disease activity, joint status, and medication adherence 1.Special Populations
Pediatrics: Transition readiness assessment crucial; use Transition Readiness Assessment Questionnaire (TRAQ) 5.0 to evaluate preparedness for adult care 1.
Adolescents/Young Adults: Highlight importance of adherence post-transition; lower adherence noted post-transfer to adult care (MMAS-4 scores) 1.
Comorbidities: Specific management strategies may be needed for comorbidities; transition support critical to ensure continuity of care 1.Key Recommendations
Assess transition readiness in pediatric patients approaching adulthood using validated tools like TRAQ 5.0 to ensure smooth healthcare transition (Evidence: Moderate) 1.
Monitor and enhance medication adherence post-transition to adult care, considering potential declines in adherence (Evidence: Moderate) 1.
Implement comprehensive transitional care programs that include psychological support and educational components to improve long-term outcomes (Evidence: Expert opinion) 1.References
1 Batu ED, Balik Z, Sener S, Aliyev E, Bayindir Y, Cam V et al.. Transitioning from pediatric to adult-oriented healthcare in rheumatology: the pediatric side of the coin. Rheumatology (Oxford, England) 2025. link