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Disease-Modifying Antirheumatic Drugs in Children With Juvenile Idiopathic Arthritis
Knowledge Gaps and Future Research Needs
The systematic review identified areas where evidence about the use of DMARDs to treat JIA is limited or absent, including:
- The comparative effectiveness of DMARDs has rarely been examined in direct, head-to-head studies.
- The effects of DMARDs on measures of inflammation and radiographic progression are unknown; their impact on JIA-associated conditions, such as uveitis and macrophage activation syndrome, has not been examined.
- The evidence is too limited to understand how patient characteristics, disease subtype, and variability in the disease process affect response to treatment.
- There are few high-quality data about the safety of DMARDs. Standardized definitions, measurement, and reporting of adverse effects associated with DMARDs are needed, together with long-term data collection.
Keywords: juvenile idiopathic arthritis | JIA | JRA | juvenile rheumatoid arthritis | JCA | DMARDs | disease-modifying | antirheumatic | anti-rheumatic | rheumatic | TNF-alpha blockers | biologic DMARD | nonbiologic DMARD | non-biologic DMARD
- Kemper A, Coeytaux R, Sanders G, et al. Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA). Comparative Effectiveness Review No. 28 (Prepared by the Duke Evidence-based Practice Center under Contract No. HHSA 290-2007-10066-I). Rockville, MD: Agency for Healthcare Research and Quality; September 2011. AHRQ Publication No. 11-EHC039-EF. Available at www.effectivehealthcare.ahrq.gov/dmardsjia.cfm.
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