16 वर्ष से कम उम्र के बच्चों में सक्रिय सैक्रोइलाइटिस के साथ पॉलीआर्टिकुलर किशोर अज्ञातहेतुक गठिया का उपचार

References

DOI: 10.1002/acr.23870

• This group includes patients with active sacroiliitis who will most likely be classified within the ILAR categories of enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis, but may include patients in any of the ILAR JIA categories.
• For the purposes of this guideline, patients were considered to have active sacroiliitis if they had prior or current magnetic resonance imaging findings consistent with sacroiliitis along with clinical examination findings consistent with sacroiliitis (e.g., pain with direct palpation of the sacroiliac joints) and/or patient-reported symptoms of inflammatory back pain.
• In children and adolescents with active sacroiliitis despite NSAIDs, adding a TNFi is strongly recommended over continued NSAID monotherapy.
• In children and adolescents with active sacroiliitis despite treatment with NSAIDs, bridging therapy with a limited course of oral glucocorticoids (<3 months) during initiation or escalation of therapy is conditionally recommended.
• In children and adolescents with active sacroiliitis despite treatment with NSAIDs, intraarticular glucocorticoid injection of the sacroiliac joints as adjunct therapy is conditionally recommended.
• In children and adolescents with sacroiliitis who have or are at risk for functional limitations, using PT is conditionally recommended.