Consensus-based recommendations for the management of uveitis associated with juvenile idiopathic arthritis: the SHARE initiative

Tamas Constantin, Ivan Foeldvari, Jordi Anton, Joke De Boer, Severine Czitrom-Guillaume, Clive Edelsten, Raz Gepstein, Arnd Heiligenhaus, Clarissa A. Pilkington, Gabriele Simonini, Yosef Uziel, Sebastian J. Vastert, Nico M. Wulffraat, Anne Mieke Haasnoot, Karoline Walscheid, Annamária Pálinkás, Reshma Pattani, Zoltán Györgyi, Richárd Kozma, Victor BoomAndrea Ponyi, Angelo Ravelli, Athimalaipet V. Ramanan*

*Corresponding author for this work

Research output: Contribution to journalArticle (Academic Journal)peer-review

44 Citations (Scopus)
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Abstract

BACKGROUND: In 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is possibly its most devastating extra-articular manifestation. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment practices differ widely, within and between nations.

OBJECTIVES: To provide recommendations for the diagnosis and treatment of JIA-associated uveitis.

METHODS: Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of nine experienced paediatric rheumatologists and three experts in ophthalmology from Europe. Recommendations derived from a validated systematic literature review were evaluated by an Expert Committee and subsequently discussed at two consensus meetings using nominal group techniques. Recommendations were accepted if >80% agreement was reached (including all three ophthalmologists).

RESULTS: In total, 22 recommendations were accepted (with >80% agreement among experts): 3 on diagnosis, 5 on disease activity measurements, 12 on treatment and 2 on future recommendations.

CONCLUSIONS: The SHARE initiative aims to identify best practices for treatment of patients suffering from JIA-associated uveitis. Within this remit, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated by an evidence-informed consensus process to suggest a standard of care for JIA-associated uveitis patients throughout Europe.

Original languageEnglish
Pages (from-to)1107-1117
Number of pages11
JournalAnnals of the Rheumatic Diseases
Volume77
Issue number8
Early online date28 Mar 2018
DOIs
Publication statusPublished - 1 Aug 2018

Keywords

  • juvenile idiopathic arthritis
  • methotrexate
  • Tnf-alpha

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