Disclaimer
is Guideline attempts to define principles of practice that should produce high-quality patient
care. It is applicable to specialists, primary care, and providers at all levels. is Guideline should
not be considered exclusive of other methods of care reasonably directed at obtaining the same
results. e ultimate judgment concerning the propriety of any course of conduct must be made by
the clinician aer consideration of each individual patient situation.
Neither IGC, the American College of Rheumatology, nor the authors endorse any product or
service associated with the distributor of this clinical reference tool.
Abbreviations
AJC, active joint count; anti-TNF, anti-tumor necrosis factor; GC, glucocorticoid; DMARD,
disease-modifying antirheumatic drug ; FDA, Food and Drug Administration; NSAID,
nonsteroidal antiinflammatory drug ; IL-1, interleukin-1; IV, intravenous; IVIG, intravenous
immune globulin; JIA, juvenile idiopathic arthritis; MAS, macrophage activation syndrome;
MD global, physician global assessment; mo, month(s); MTX, methotrexate; Rx, treatment;
TB, tuberculosis; TNF-α, tumor necrosis factor; wk, week(s)
Source
Ringold S, Weiss PF, Beukelman T, DeWitt EM, Ilowite NT, Kimura Y, Laxer RM, Lovell DJ,
Nigrovic PA, Robinson AB, Vehe RK; American College of Rheumatolog y. 2013 update of
the 2011 American College of Rheumatolog y recommendations for the treatment of juvenile
idiopathic arthritis: recommendations for the medical therapy of children with systemic juvenile
idiopathic arthritis and tuberculosis screening among children receiving biologic medications.
Arthritis Rheum. 2013 Oct;65(10):2499-512. doi: 10.1002/art.38092. Copublished in Arthritis
Care Res (Hoboken). 2013 Oct;65(10):1551-63.
106 Commerce Street, Suite 105
Lake Mary, FL 32746
TEL: 407.878.7606 • FAX: 407.878.7611
For additional copies, order at GuidelineCentral.com
Copyright © 2015 All rights reserved
Quality of Evidence
Level Description
A Randomized controlled trials
B Nonrandomized studies, including retrospective cohort studies and
extrapolation from randomized controlled trials
C Uncontrolled studies, including case series and extrapolation from a
nonrandomized study or more complex extrapolation from a randomized
controlled trial
D Expert opinion
Appropriate Panel median of 7-9, without disagreement
Uncertain Panel median of 4-6 OR any median with disagreement
Inappropriate Panel median of 1-3, without disagreement
Derived from the RAND/UCLA Appropriateness Method User's Manual.
http://www.rand.org/content/dam/rand/pubs/monograph_reports/2011/MR1269.pdf
ACRJIA15123b
