6
Treatment
Table 4. TMJ Arthritis
Recommendations Certainty of Evidence
A trial of consistent NSAIDs is conditionally recommended
as part of initial therapy.
Very low
IAGCs are conditionally recommended as part of initial
therapy.
Very low
ere is no preferred agent.
Oral glucocorticoids are conditionally recommended against
as part of initial therapy.
Very low
Conventional synthetic DMARDs are strongly
recommended for inadequate response or intolerance to
NSAIDs and/or IAGCs.
Very low
Methotrexate is conditionally recommended as a preferred
agent over leflunomide.
Biologic DMARDs are conditionally recommended for
inadequate response or intolerance to NSAIDs and/or
IAGCs and at least one conventional synthetic DMARD.
Very low
ere is no preferred biologic agent.
Consideration of poor prognostic features (e.g., involvement
of ankle, wrist, hip and/or TMJ, presence of erosive disease,
delay in diagnosis, elevated inflammatory markers, symmetric
disease) is conditionally recommended to guide treatment
decisions.
Very low
Table 5. Systemic JIA Inactive Disease
Recommendations Certainty of Evidence
Tapering and discontinuing glucocorticoids is strongly
recommended aer inactive disease has been attained.
Very low
Tapering and discontinuing biologic DMARDs is
conditionally recommended aer inactive disease has been
attained.
Very low
