This protocol covers first-line management for children diagnosed with juvenile idiopathic arthritis (JIA) who present with non-systemic polyarthritis involving 5 or more joints, with onset before age 16 and no systemic arthritis or sacroiliitis.

Clinical Scenario

Juvenile idiopathic arthritis (JIA) defines a heterogeneous group of inflammatory arthritides of unknown cause with onset before age 16 years and a minimum duration of 6 weeks, after exclusion of other known causes of synovitis. This sub-population includes children with polyarthritis (5 or more joints ever involved) but explicitly excludes those with systemic arthritis or sacroiliitis.

Treatment Approach

Initial therapy centres on disease-modifying antirheumatic (DMARD) treatment, with specific administration preferences, alongside adjunct options targeting inflammation and functional support — the complete regimen, sequencing, and prescribing details are in the full protocol.

References

DOI: 10.1002/acr.23870

The term juvenile idiopathic arthritis (JIA) defines a heterogeneous collection of inflammatory arthritides of unknown etiology with onset prior to age 16 years and a minimum duration of 6 weeks, following the exclusion of other known causes of synovitis.
This group includes children with JIA and polyarthritis (≥5 joints ever involved) and may include children from different ILAR JIA categories but excludes children with systemic arthritis or sacroiliitis.
Initial therapy with a DMARD is strongly recommended over NSAID monotherapy.
Good disease control, with therapeutic escalation to achieve low disease activity, was recommended.

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Treatment of Polyarticular Juvenile Idiopathic Arthritis in Juvenile Idiopathic Arthritis — Non-Systemic, 5 or More Joints

Clinical Scenario

Treatment Approach

Treatment Target

References