Treatment
Systemic JIA With Active Systemic Features and Varying Degrees of Synovitis
Figure 1. Treatment Pathways
Patient With Active
& Varying Degrees
MD global ≥5
& AJC irrespective
Initial Disease
Activity
MD global <5
& AJC >4
MD global <5
& AJC 1-4
MD global ≤5
& AJC 0
Anakinra
INITIAL
THERAPY
Continued Disease
Activity
GC monotherapy
(oral or IV)
NSAIDs
MD global
irrespective, AJC 0-4
Disease activity
following 1 month of
anakinra
MD global
irrespective, AJC >4
Disease activity
following 2 weeks of
GC monotherapy
MD global ≥5,
AJC irrespective
MD global <5,
AJC=0
MD global <5 &
AJC >0
MD global <5, AJC=0
Disease activity
following 1 month of
NSAIDs
MD global <5,
AJC >0
MD global ≥5,
AJC irrespective
Adjunct intra-articular GC injection appropriate at any time (C)
Adjuct systemic GC as needed (C)
C
C
C
C
C
D
D
D
