References

mrj

Современная ревматология

Modern Rheumatology Journal

1996-70122310-158X

IMA-PRESS, LLC

10.14412/1996-7012-2014-3-9-22

mrj-567

Research Article

Современные рекомендации: диагностика, лечение

CURRENT GUIDELINES: DIAGNOSIS, TREATMENT

Пересмотр рекомендаций Американской коллегии ревматологов-2011 по лечению ювенильного идиопатического артрита (2013 г.)

2013 Update of the 2011 American College of Rheumatology Recommendations for the Treatment of Juvenile Idiopathic Arthritis

Ringold

Sarah

Ringold

Sarah

F. Weiss

Pamela

Weiss

Pamela F.

Beukelman

Timothy

Beukelman

Timothy

DeWitt

Esi Morgan

DeWitt

Esi Morgan

T. Ilowite

Norman

Ilowite

Norman T.

Kimura

Yukiko

Kimura

Yukiko

M. Laxer

Ronald

Laxer

Ronald M.

J. Lovell

Daniel

Lovell

Daniel J.

A. Nigrovic

Peter

Nigrovic

Peter A.

Byun Robinson

Angela

Robinson

Angela Byun

K. Vehe

Richard

Vehe

Richard K.

Детский госпиталь г. Сиэтла, штат ВашингтонRussian FederationДетский госпиталь г. Филадельфия, штат ПенсильванияRussian FederationУниверситет Алабамы в БирмингемеRussian FederationМедицинский центр детского госпиталя г. Цинциннати, штат ОгайоRussian FederationМедицинский колледж им. Альберта Эйнштейна и детский госпиталь Монтефиоре, Бронкс, Нью-ЙоркRussian FederationМедицинский центр г. Хаккенсак, штат Нью-ДжерсиRussian FederationГоспиталь для больных детей, г. Торонто, провинция Онтарио, КанадаRussian FederationЖенская больница Бригама, г. Бостон, штат МассачусетсRussian FederationГоспиталь для детей и младенцев Рейнбоу, г. Кливленд, штат ОгайоRussian FederationУниверситет Миннесоты, МиннеаполисRussian Federation

2014

22092014

83922

2014

Ringold S., F. Weiss P., Beukelman T., DeWitt E., T. Ilowite N., Kimura Y., M. Laxer R., J. Lovell D., A. Nigrovic P., Byun Robinson A., K. Vehe R.

Ringold S., Weiss P., Beukelman T., DeWitt E., Ilowite N., Kimura Y., Laxer R., Lovell D., Nigrovic P., Robinson A., Vehe R.

Данная работа распространяется под лицензией Creative Commons Attribution 4.0.

This work is licensed under a Creative Commons Attribution 4.0 License.

https://mrj.ima-press.net/mrj/article/view/567

Guidelines and recommendations developed and/or endorsed by the American College of Rheumatology (ACR) are intended to provide guidance for particular patterns of practice and not to dictate the care of a particular patient.The ACR considers adherence to these guidelines and recommendations to be voluntary, with the ultimate determination regarding their application to be made by the physician in light of each patient’s individual circumstances.

Guidelines and recommendations are intended to promote beneficial or desirable outcomes but cannot guarantee any specific outcome. Guidelines and recommendations developed or endorsed by the ACR are subject to periodic revision as warranted by the evolution of medical knowledge, technology, and practice.

The American College of Rheumatology is an independent, professional, medical and scientific society which does not guarantee, warrant, or endorse any commercial product or service.

ООО «Новартис Фарма»

References1

Beukelman T, Patkar NM, Saag KG, et al. 2011 American College of Rheumatology recommendations for the treatment of juvenile idiopathic arthritis: initiation and safety monitoring of therapeutic agents for the treatment of arthritis and systemic features. Arthritis Care Res (Hoboken). 2011;63(4):465–82. DOI: 10.1002/acr.20460..

Petty RE, Southwood TR, Manners P, et al. International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001. J Rheumatol. 2004;31(2):390–2.

Singh-Grewal D, Schneider R, Bayer N, Feldman BM. Predictors of disease course and remission in systemic juvenile idiopathic arthritis: significance of early clinical and laboratory features. Arthritis Rheum. 2006;54(5):1595–601. DOI: http://dx.doi.org/10.1002/art.21774.

Lomater C, Gerloni V, Gattinara M, et al. Systemic onset juvenile idiopathic arthritis: a retrospective study of 80 consecutive patients followed for 10 years. J Rheumatol. 2000;27(2):491–6.

Spiegel LR, Schneider R, Lang BA, et al. Early predictors of poor functional outcome in systemiconset juvenile rheumatoid arthritis: a multicenter cohort study. Arthritis Rheum. 2000;43(11):2402–9. DOI: http://dx.doi.org/10.1002/1529-0131(200011)43:11%3C2402: AID-ANR5%3E3.0.CO;2-C.

Mellins ED, Macaubas C, Grom AA. Pathogenesis of systemic juvenile idiopathic arthritis: some answers, more questions. Nat Rev Rheumatol. 2011;7(7):416–26. DOI: 10.1038/nrrheum.2011.68.

Martini A. Systemic juvenile idiopathic arthritis. Autoimmun Rev. 2012;12(1):56–9. DOI: 10.1016/j.autrev.2012.07.022. Epub 2012 Aug 2.

Behrens EM, Beukelman T, Paessler M, Cron RQ. Occult macrophage activation syndrome in patients with systemic juvenile idiopathic arthritis. J Rheumatol. 2007;34(5):1133–8. Epub 2007 Mar 1.

Behrens EM, Beukelman T, Gallo L, et al. Evaluation of the presentation of systemic onset juvenile rheumatoid arthritis: data from the Pennsylvania Systemic Onset Juvenile Arthritis Registry (PASOJAR). J Rheumatol. 2008;35(2):343–8. Epub 2007 Dec 15.

Bennett TD, Fluchel M, Hersh AO, et al. Macrophage activation syndrome in children with systemic lupus erythematosus and children with juvenile idiopathic arthritis. Arthritis Rheum. 2012;64(12):4135–42. DOI: 10.1002/art.34661.

Sawhney S, Woo P, Murray KJ. Macrophage activation syndrome: a potentially fatal complication of rheumatic disorders. Arch Dis Child. 2001;85(5):421–6. DOI: http://dx.doi.org/10.1136/adc.85.5.421.

Fitch K, Bernstein S, Aguilar M, et al. The RAND/UCLA appropriateness method user’s manual. Santa Monica (CA): RAND; 2001.

Sampson M, McGowan J, Lefebvre C, Moher DG. PRESS: peer review of electronic search strategies. Ottawa (ON): Canadian Agency for Drugs and Technologies in Health; 2008.

Ruperto N, Brunner HI, Quartier P, et al. Two randomized trials of canakinumab in systemic juvenile idiopathic arthritis. N Engl J Med. 2012;367(25):2396–406. DOI: 10.1056/NEJMoa1205099.

De Benedetti F, Brunner HI, Ruperto N, Kenwright A, Wright S, Calvo I, et al. Randomized trial of tocilizumab in systemic juvenile idiopathic arthritis. N Engl J Med. 2012;367(25):2385–95. DOI:10.1056/NEJMoa1112802.

CEBM, Centre for Evidence-Based Medicine. Oxford Centre for Evidence-Based Medicine: levels of evidence (March 2009). Oxford (UK): Oxford Centre for Evidence- Based Medicine; 2009. Availble from: http://www.cebm.net/index.aspx?o_1025.

Quartier P, Allantaz F, Cimaz R, et al. A multicentre, randomised, double-blind, placebo-controlled trial with the interleukin-1 receptor antagonist anakinra in patients with systemic-onset juvenile idiopathic arthritis (ANAJIS trial). Ann Rheum Dis. 2011;70(5):747–54. DOI:10.1136/ard.2010.134254. Epub 2010 Dec 20.

Nigrovic PA, Mannion M, Prince FH, et al. Anakinra as first-line disease-modifying therapy in systemic juvenile idiopathic arthritis: report of forty-six patients from an international multicenter series. Arthritis Rheum. 2011;63(5):545–55. DOI: 10.1002/art.30128.

Hedrich CM, Bruck N, Fiebig B, Gahr M. Anakinra: a safe and effective first-line treatment in systemic onset juvenile idiopathic arthritis (SoJIA). Rheumatol Int. 2012;32(11):3525–30. DOI: 10.1007/s00296-011-2249-4. Epub 2011 Nov 15.

Pay S, Turkcapar N, Kalyoncu M, et al. A multicenter study of patients with adultonset Still’s disease compared with systemic juvenile idiopathic arthritis. Clin Rheumatol. 2006;25(5):639–44. DOI: http://dx.doi.org/10.1007/s10067-005-0138-5. Epub 2005 Dec 20.

Picco P, Gattorno M, Buoncompagni A, et al. 6-methylprednisolone «mini-pulses»: a new modality of glucocorticoid treatment in systemic onset juvenile chronic arthritis. Scand J Rheumatol. 1996;25(1):24–7. DOI: http://dx.doi.org/10.3109/03009749609082663.

Swart JF, Barug D, Mohlmann M, Wulffraat NM. The efficacy and safety of interleukin-1-receptor antagonist anakinra in the treatment of systemic juvenile idiopathic arthritis. Expert Opin Biol Ther. 2010;10(12):1743–52. DOI: 10.1517/14712598.2010.532785. Epub 2010 Oct 28.

Zeft A, Hollister R, LaFleur B, et al. Anakinra for systemic juvenile arthritis: the Rocky Mountain experience. J Clin Rheumatol. 2009;15(4):161–4. DOI: 10.1097/RHU.0b013e3181a4f459.

Ohlsson V, Baildam E, Foster H, et al. Anakinra treatment for systemic onset juvenile idiopathic arthritis (SOJIA). Rheumatology (Oxford). 2008;47(4):555–6. DOI: 10.1093/rheumatology/ken030. Epub 2008 Mar 5.

Pascual V, Allantaz F, Arce E, et al. Role of interleukin-1 (IL-1) in the pathogenesis of systemic onset juvenile idiopathic arthritis and clinical response to IL-1 lockade. J Exp Med. 2005;201(9):1479–86. DOI: http://dx.doi.org/10.1084/jem.20050473. Epub 2005 Apr 25.

Merlin E, Berthomieu L, Dauphin C, Stephan JL. Cardiac tamponade in a child with systemic-onset juvenile idiopathic arthritis: dramatic improvement after interleukin-1 blockade by anakinra. Pediatr Cardiol. 2011;32(6):862–3. DOI: 10.1007/s00246- 011-0009-6.

Mirkinson LJ, Nagle D, Kadom N, Jones OY. Anakinra therapy in a child with systemic-onset juvenile rheumatoid arthritis after human herpesvirus 6 encephalitis. J Clin Rheumatol. 2006;12(2):83–6. DOI: http://dx.doi.org/10.1097/01.rhu. 0000208650.99508.4e.

Verbsky JW, White AJ. Effective use of the recombinant interleukin 1 receptor antagonist anakinra in therapy resistant systemic onset juvenile rheumatoid arthritis. J Rheumatol. 2004;31(10):2071–5.

Gattorno M, Piccini A, Lasiglie D, et al. The pattern of response to anti-interleukin-1 treatment distinguishes two subsets of patients with systemic-onset juvenile idiopathic arthritis. Arthritis Rheum. 2008;58(5):1505–15. DOI: 10.1002/art.23437.

Lequerre T, Quartier P, Rosellini D, et al. Interleukin-1 receptor antagonist (anakinra) treatment in patients with systemic-onset juvenile idiopathic arthritis or adult onset Still disease: preliminary experience in France. Ann Rheum Dis. 2008;67(3):302–8. DOI: http://dx.doi.org/10.1136/ard.2007.076034. Epub 2007 Oct 18.

Ruperto N, Ravelli A, Castell E, et al. Cyclosporine A in juvenile idiopathic arthritis: results of the PRCSG/PRINTO phase IV post marketing surveillance study. Clin Exp Rheumatol. 2006;24(5):599–605.

Ravelli A, Moretti C, Temporini F, et al. Сombination therapy with methotrexate and cyclosporine A in juvenile idiopathic arthritis. Clin Exp Rheumatol. 2002;20(4):569–72.

Gerloni V, Cimaz R, Gattinara M, et al. Efficacy and safety profile of cyclosporin A in the treatment of juvenile chronic (idiopathic) arthritis: results of a 10-year prospective study. Rheumatology (Oxford). 2001;40(8):907–13. DOI: http://dx.doi.org/10.1093/rheumatology/ 40.8.907.

Reiff A, Rawlings DJ, Shaham B, et al. Preliminary evidence for cyclosporin A as an alternative in the treatment of recalcitrant juvenile rheumatoid arthritis and juvenile dermatomyositis. J Rheumatol. 1997;24(12):2436–43.

Pistoia V, Buoncompagni A, Scribanis R, et al. Cyclosporin A in the treatment of juvenile chronic rthritis and childhood polymyositis-dermatomyositis: results of a preliminary study. Clin Exp Rheumatol. 1993;11(2):203–8.

Ostensen M, Hoyeraal HM, Kass E. Tolerance of cyclosporine A in children with refractory juvenile rheumatoid arthritis. J Rheumatol. 1988;15(10):1536–8.

Ruperto N, Quartier P, Wulffraat N, et al.; Paediatric Rheumatology International Clinical Trials Organisation. A phase II, multicenter, open-label study evaluating dosing and preliminary safety and efficacy of canakinumab in systemic juvenile idiopathic arthritis with active systemic features. Arthritis Rheum. 2012;64(2):557–67. DOI: 10.1002/art.33342.

Bloom BJ, Alario AJ, Miller LC. Intraarticular corticosteroid therapy for juvenile idiopathic arthritis: report of an experiential cohort and literature review. Rheumatol Int. 2011;31(6):749–56. DOI: 10.1007/s00296-010-1365-x. Epub 2010 Feb 14.

Lanni S, Bertamino M, Consolaro A, et al. Outcome and predicting factors of single and multiple intra-articular corticosteroid injections in children with juvenile idiopathic arthritis. Rheumatology (Oxford). 2011;50(9):1627–34. DOI: 10.1093/rheumatology/ker165. Epub 2011 May 11.

Woo P, Southwood TR, Prieur AM, et al. Randomized, placebo-controlled, crossover trial of low-dose oral methotrexate in children with extended oligoarticular or systemic arthritis. Arthritis Rheum. 2000;43(8):1849–57. DOI: http://dx.doi.org/10.1002/1529- 0131(200008)43:8%3C1849::AIDANR22%3E3.0.CO;2-F.

Russo RA, Katsicas MM. Clinical remission in patients with systemic juvenile idiopathic arthritis treated with anti-tumor necrosis factor agents. J Rheumatol. 2009;36(5):1078–82. DOI: http://dx.doi.org/10.3899/jrheum.090952.

Kimura Y, Pinho P, Walco G, et al. Etanercept treatment in patients with refractory systemic onset juvenile rheumatoid arthritis. J Rheumatol. 2005;32(5):935–42.

Inaba Y, Ozawa R, Aoki C, et al. Radiologic analysis of the effect of tocilizumab on hands and large joints in children with systemic juvenile idiopathic arthritis. Mod Rheumatol. 2013 Jul;23(4):667–73. DOI: 10.1007/s10165-012-0711-0. Epub 2012 Jul 13.

Yokota S, Miyamae T, Imagawa T, et al. Therapeutic efficacy of humanized recombinant anti- interleukin-6 receptor antibody in children with systemic-onset juvenile idiopathic arthritis. Arthritis Rheum. 2005;52(3):818–25. DOI: http://dx.doi.org/10.1002/art.20944.

Woo P, Wilkinson N, Prieur AM, et al. Open label phase II trial of single, ascending doses of MRA in Caucasian children with severe systemic juvenile idiopathic arthritis: proof of principle of the efficacy of IL-6 receptor blockade in this type of arthritis and demonstration of prolonged clinical improvement. Arthritis Res Ther. 2005;7(6):R1281–8. DOI: http://dx.doi.org/10.1186/ar1826. Epub 2005 Sep 15.

Inaba Y, Ozawa R, Imagawa T, et al. Radiographic improvement of damaged large joints in children with systemic juvenile idiopathic arthritis following tocilizumab treatment. Ann Rheum Dis. 2011;70(9):1693–5. DOI: http://dx.doi.org/10.1136/ard.2010.145359.

De La Torre M, Arboleya L, Pozo S, et al. Rapid and sustained response to tocilizumab, anti-interleukin-6 receptor antibody, in a patient with nephrotic syndrome secondary to systemic juvenile idiopathic arthritis-related amyloidosis. NDT Plus. 2011;(4):178–80. DOI: http://dx.doi.org/10.1093/ndtplus/sfr004.

Yokota S, Imagawa T, Mori M, Miyamae T, et al. Long-term treatment of systemic juvenile idiopathic arthritis with tocilizumab: results of an open-label extension study in Japan. Ann Rheum Dis. 2013;72(4):627–8. DOI: http://dx.doi.org/10.1136/ annrheumdis-2012-202310.

Yokota S, Imagawa T, Mori M, et al. Efficacy and safety of tocilizumab in patients with systemic onset juvenile idiopathic arthritis: a randomised, double-blind, placebocontrolled, withdrawal phase III trial. Lancet 2008;371(9617):998–1006. DOI: http://dx.doi.org/10.1016/S0140-6736(08)60454-7.

Becker ML, Rose CD, Cron RQ, et al. Effectiveness and toxicity of methotrexate in juvenile idiopathic arthritis: comparison of 2 initial dosing regimens. J Rheumatol. 2010;37(4):870–5. DOI: http://dx.doi.org/10.3899/jrheum.090826.

Klein A, Kaul I, Foeldvari I, et al. Efficacy and safety of oral and parenteral methotrexate therapy in children with juvenile idiopathic arthritis: an observational study with patients from the German Methotrexate Registry. Arthritis Care Res. (Hoboken) 2012;64(9):1349–56. DOI: 10.1002/acr.21697.

Foeldvari I, Wierk A. Effectiveness of leflunomide in patients with juvenile idiopathic arthritis in clinical practice. J Rheumatol. 2010;37(8):1763–7. DOI: 10.3899/jrheum.090874. Epub 2010 May 15.

Jahan A, Dewan V, Yadav TP. Leflunomide in systemic onset juvenile idiopathic arthritis. Indian Pediatr. 2012;49(9):750–2. DOI: http://dx.doi.org/10.1007/s13312-012-0139-9.

Record JL, Beukelman T, Cron RQ. Combination therapy of abatacept and anakinra in children with refractory systemic juvenile idiopathic arthritis: a retrospective case series. J Rheumatol. 2011;38(1):180–1. DOI: 10.3899/jrheum.100726.

Ruperto N, Lovell DJ, Quartier P, et al.; Paediatric Rheumatology International Trials Organization and the Pediatric Rheumatology Collaborative Study Group. Long-term safety and efficacy of abatacept in children with juvenile idiopathic arthritis. Arthritis Rheum. 2010;62(6):1792–802. DOI: 10.1002/art.27431.

Ruperto N, Lovell DJ, Li T, et al.; Paediatric Rheumatology International Trials Organization (PRINTO); Pediatric Rheumatology Collaborative Study Group (PRCGS). Abatacept improves health-related quality of life, pain, sleep quality, and daily participation in subjects with juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2010;62(11):1542–51. DOI: 10.1002/acr.20283. Epub 2010 Jul 1.

Ruperto N, Lovell DJ, Quartier P, et al. Abatacept in children with juvenile idiopathic arthritis: a randomised, double-blind, placebo-controlled withdrawal trial. Lancet.2008;372(9636):383–91. DOI: 10.1016/S0140-6736(08)60998-8. Epub 2008 Jul 14.

Ilowite N, Porras O, Reiff A, et al. Anakinra in the treatment of polyarticularcourse juvenile rheumatoid arthritis: safety and preliminary efficacy results of a randomized multicenter study. Clin Rheumatol. 2009;28(2):129–37. DOI: 10.1007/s10067-008-0995-9. Epub 2008 Sep 3.

Papsdorf V, Horneff G. Complete control of disease activity and remission induced by treatment with etanercept in juvenile idiopathic arthritis. Rheumatology (Oxford). 2011;50(1):214–21. DOI: 10.1093/rheumatology/keq292.

Otten MH, Prince FH, Armbrust W, et al. Factors associated with treatment response to etanercept in juvenile idiopathic arthritis. JAMA. 2011;306(21):2340–7. DOI: 10.1001/jama.2011.1671. Epub 2011 Nov 6.

Zuber Z, Rutkowska-Sak L, Postepski J, et al. Etanercept treatment in juvenile idiopathic arthritis: the Polish registry. Med Sci Monit. 2011;17(12):SR35–42. DOI: http://dx.doi.org/10.12659/MSM.882109.

Miettunen PM, Narendran A, Jayanthan A, et al. Successful treatment of severe paediatric rheumatic diseaseassociated macrophage activation syndrome with interleukin-1 inhibition following conventional immunosuppressive therapy: case series with 12 patients. Rheumatology (Oxford). 2011;50(2):417–9. DOI: 10.1093/rheumatology/keq218. Epub 2010 Aug 7.

Bruck N, Suttorp M, Kabus M, et al. Rapid and sustained remission of systemic juvenile idiopathic arthritis-associated macrophage activation syndrome through treatment with anakinra and corticosteroids. J Clin Rheumatol. 2011;17(1):23–7. DOI: 10.1097/RHU.0b013e318205092d.

Kelly A, Ramanan AV. A case of macrophage activation syndrome successfully treated with anakinra. Nat Clin Pract Rheumatol. 2008;4(11):615–20. DOI: 10.1038/ncprheum0919. Epub 2008 Sep 30.

Mouy R, Stephan JL, Pillet P, et al. Efficacy of cyclosporine A in the treatment of macrophage activation syndrome in juvenile arthritis: report of five cases. J Pediatr. 1996;129(5):750–4.

Mizrahi M, Ben-Chetrit E. Relapsing macrophage activating syndrome in a 15- year-old girl with Still’s disease: a case report. J Med Case Rep. 2009;(3):138. DOI: 10.1186/1752-1947-3-138.

Hur M, Kim YC, Lee KM, Kim KN. Macrophage activation syndrome in a child with systemic juvenile rheumatoid arthritis. J Korean Med Sci. 2005;20(4):695–8. DOI: http://dx.doi.org/10.3346/jkms.2005.20.4.695.

Ravelli A, De Benedetti F, Viola S, Martini A. Macrophage activation syndrome in systemic juvenile rheumatoid arthritis successfully treated with cyclosporine. J Pediatr. 1996;128(2):275–8. DOI: http://dx.doi.org/10.1016/S0022-3476(96)70408-0.

Cortis E, Insalaco A. Macrophage activation syndrome in juvenile idiopathic arthritis. Acta Paediatr Suppl. 2006;95(452):38–41. DOI: http://dx.doi.org/10.1080/ 08035320600649713.

Cuende E, Vesga JC, Perez LB, et al. Macrophage activation syndrome as the initial manifestation of systemic onset juvenile idiopathic arthritis. Clin Exp Rheumatol. 2001;19(6):764–5.

Hadchouel M, Prieur AM, Griscelli C. Acute hemorrhagic, hepatic, and neurologic manifestations in juvenile rheumatoid arthritis: possible relationship to drugs or infection. J Pediatr. 1985;106(4):561–6. DOI: http://dx.doi.org/10.1016/S0022- 3476(85)80072-X.

Ilowite NT, Sandborg CI, Feldman BM, et al. Algorithm development for corticosteroid management in systemic juvenile idiopathic rthritis trial using consensus methodology. Pediatr Rheumatol Online J. 2012;10(1):31. DOI: 10.1186/1546-0096-10-31.

Ravelli A, Magni-Manzoni S, Pistorio A, et al. Preliminary diagnostic guidelines for macrophage activation syndrome complicating systemic juvenile idiopathic arthritis. J Pediatr. 2005;146(5):598–604. DOI: http://dx.doi.org/10.1016/j.jpeds.2004.12.016.

Davi S, Consolaro A, Guseinova D, et al. An international consensus survey of diagnostic criteria for macrophage activation syndrome in systemic juvenile idiopathic arthritis. J Rheumatol. 2011;38(4):764–8. DOI: 10.3899/jrheum.100996. Epub 2011 Feb 1.

Red Book: 2009 report of the Committee on Infectious Diseases. 28th ed. Elk Grove Village (IL): American Academy of Pediatrics; 2009.

Mazurek GH, Jereb J, Vernon A, et al. Updated guidelines for using interferon Gamma Release Assays to detect Mycobacterium tuberculosis infection – United States, 2010. MMWR Recomm Rep. 2010;59(PR–5):1–25.

DeWitt EM, Kimura Y, Beukelman T, et al. Consensus treatment plans for new-onset systemic juvenile idiopathic arthritis. Arthritis Care Res (Hoboken). 2012;64(7):1001–10. DOI: 10.1002/acr.21625.

The authors declare that there are no conflicts of interest present.