Este protocolo aborda a artrite idiopática juvenil poliarticular em pacientes menores de 16 anos com sacroileíte ativa confirmada por ressonância magnética e achados clínicos, e que apresentam contraindicação à terapia com inibidor do fator de necrose tumoral.
A evidência atual apoia fortemente o tratamento com AINEs como parte da abordagem de manejo da sacroileíte ativa nesta população. O esquema terapêutico estruturado completo — incluindo sequenciamento e todas as considerações relevantes — está disponível no protocolo completo.
DOI: 10.1002/acr.23870
In children and adolescents with active sacroiliitis, treatment with an NSAID is strongly recommended over no treatment with an NSAID.
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.
Using sulfasalazine for patients who have contraindications to TNFi or have failed more than one TNFi is conditionally recommended.
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