7
Table 6. Systemic JIA Without MAS
Recommendations Certainty of Evidence
NSAIDs are conditionally recommended as initial
monotherapy.
Very low
Oral glucocorticoids are conditionally recommended against
as initial monotherapy.
Conventional synthetic DMARDs are strongly
recommended against as initial monotherapy.
Very low
Biologic DMARDs (interleukin [IL-1 and IL-6 inhibitors])
are conditionally recommended as initial monotherapy.
Very low
ere is no preferred agent.
IL-1 and IL-6 inhibitors are strongly recommended over a
single or combination of conventional synthetic DMARDs
for inadequate response to or intolerance of NSAIDs and/or
glucocorticoids.
Very low
Biologic DMARDS or conventional synthetic DMARDS
are strongly recommended over long-term glucocorticoids
for residual arthritis and incomplete response to IL-1 and/or
IL-6 inhibitors.
Very low
ere is no preferred agent.
Table 7. Systemic JIA With MAS
Recommendations Certainty of Evidence
IL-1 and IL-6 inhibitors are conditionally recommended over
calcineurin inhibitors alone to achieve inactive disease and
resolution of MAS.
Very low
Glucocorticoids are conditionally recommended as part of
initial treatment of systemic JIA with MAS.
ere is no preferred agent.
Biologic DMARDs or conventional synthetic DMARDs are
strongly recommended over long-term glucocorticoids for
residual arthritis and an incomplete response to IL-1 and/or
IL-6 inhibitors.
Very low
ere is no preferred agent.
