Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis
Treatment
Recommendations for ophthalmic screening
- Ophthalmic screening every 3 months is conditionally recommended.
Recommendations for ophthalmic monitoring
Recommendations for glucocorticoid use
In children and adolescents with JIA and active CAU:
In children and adolescents with JIA and CAU still requiring 1–2 drops/day of prednisolone acetate 1% (or equivalent) for uveitis control:
In children and adolescents with JIA who develop new CAU activity despite stable systemic therapy:c
Topical glucocorticoids prior to changing/escalating systemic therapy is conditionally recommended over changing/escalating systemic therapy immediately.
( Conditional , Very Low )Recommendations for DMARDs and biologics
Recommendations for education about and treatment of AAU
Recommendations for tapering therapy for uveitis:
a Each recommendation had very low quality level of evidence.
b High-risk children are those with oligoarthritis, polyarthritis (rheumatoid factor negative), psoriatic arthritis, or undifferentiated arthritis who are also antinuclear antibody positive, younger than 7 years of age at JIA onset, and have JIA duration of 4 years or less.
c Definition of new CAU activity: no prior uveitis or loss of control of previously controlled uveitis.
Recommendation Grading
Overview
Title
Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis
Authoring Organization
American College of Rheumatology
Publication Month/Year
April 25, 2019
Last Updated Month/Year
February 23, 2024
Supplemental Implementation Tools
Document Type
Guideline
External Publication Status
Published
Country of Publication
US
Document Objectives
To develop recommendations for the screening, monitoring, and treatment of uveitis in children with juvenile idiopathic arthritis (JIA).
Inclusion Criteria
Male, Female, Adolescent, Child, Infant
Health Care Settings
Ambulatory, Childcare center, Outpatient
Intended Users
Nurse, nurse practitioner, optometrist, physician, physician assistant
Scope
Assessment and screening, Treatment, Management
Diseases/Conditions (MeSH)
D014605 - Uveitis, D001171 - Arthritis, Juvenile
Keywords
juvenile idiopathic arthritis, uveitis, JIA
Source Citation
Angeles‐Han, S.T., Ringold, S., Beukelman, T., Lovell, D., Cuello, C.A., Becker, M.L., Colbert, R.A., Feldman, B.M., Holland, G.N., Ferguson, P.J., Gewanter, H., Guzman, J., Horonjeff, J., Nigrovic, P.A., Ombrello, M.J., Passo, M.H., Stoll, M.L., Rabinovich, C.E., Sen, H.N., Schneider, R., Halyabar, O., Hays, K., Shah, A.A., Sullivan, N., Szymanski, A.M., Turgunbaev, M., Turner, A. and Reston, J. (2019), 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Screening, Monitoring, and Treatment of Juvenile Idiopathic Arthritis–Associated Uveitis. Arthritis Care Res, 71: 703-716. doi:10.1002/acr.23871
Supplemental Methodology Resources
Data Supplement, Data Supplement, Data Supplement, Data Supplement, Data Supplement