Interdisziplinäre S2-Therapieleitlinie der Juvenilen Idiopathischen Arthritis

Zusammenfassung

Die Therapie der Juvenilen Idiopathischen Arthritis (JIA) hat zu einer Verbesserung der Lebensqualität von Kindern und Jugendlichen geführt, variiert aber von Behandler zu Behandler noch erheblich. Eine Standardisierung der Therapie auf der Basis von Konsensusempfehlungen bietet die Chance, die Qualität der Versorgung von Kindern und Jugendlichen mit JIA weiter zu verbessern.

Ziel der Untersuchung: Evidenzbasierte S2- Leitlinie zum Thema JIA, basierend auf der bestehenden Leitlinie von 2005.

Methodik: Eine systematische Literaturanalyse wurde durchgeführt. Als Stichwörter wurden verwandt: juvenile idiopathic (rheumatoid) arthritis and therapy; als Suchbegrenzungen (Limits) in PUBMED: humans, published in the last 3 years, all child 0–18 years, clinical trial. Ausgeschlossen wurden Studien zur Diagnostik der JIA, Uveitis, Impfung, Transition und Rofecoxib. Die Autoren der GKJR-Leitlinie von 2005 und Vertreter aus folgenden Fachgesellschaften und Vereinigungen wurden zu professionell moderierten Konsensuskonferenzen eingeladen: Berufsverband der Kinder- und Jugendärzte (BVKJ), Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Deutsche Gesellschaft für Rheumatologie (DGRh), Deutsche Ophthalmologische Gesellschaft (DOG), Deutsche Rheuma-Liga Bundesverband, Verein zur Förderung und Unterstützung rheumatologisch erkrankter Kinder und deren Eltern, Vereinigung für Kinderorthopädie, Zentraler Verband der Physiotherapeuten und Krankengymnasten (ZVK). Die Konsensuskonferenzen am 9.5. und 1.8.2007 in Düsseldorf fanden unter >95% Teilnahme statt und die Konsensus-Statements wurden abschließend im Delphiverfahren abgestimmt.

Resultate und Zusammenfassung: Zu den Themen medikamentöse, symptomatische und chirurgische JIA-Therapie wurden Statements im Konsens erarbeitet und nach den Kriterien der evidenzbasierten Medizin bewertet.

Abstract

Treatment of Juvenile Idiopathic Arthritis (JIA) has improved quality of life in children and adolescents suffering from JIA. However, it varies considerably from caregiver to caregiver. Therefore a standardisation of care on the basis of consensus treatment recommendations offers the chance to further improve the quality of care for children and adolescents with JIA. We aimed to establish an interdisciplinary, evidence-based treatment guideline for JIA based on the existing guideline from 2005.

Methods: We did a systematic literature analysis in PUBMED with the key words “juvenile idiopathic (rheumatoid) arthritis” and “therapy”. As limits in PUBMED we used: humans, published in the last 3 years, all child 0–18 years, clinical trial. Studies relating to diagnosis of JIA, Uveitis, vaccination, transition and rofexocibe were excluded. Authors of the 2005 guideline and representatives nominated by different societies were invited to attend the consensus conferences which were hosted by a professional moderator. Following societies were invited: Berufsverband der Kinder- und Jugendärzte (BVKJ), Deutsche Gesellschaft für Kinder- und Jugendmedizin (DGKJ), Deutsche Gesellschaft für Rheumatologie (DGRh), Deutsche Ophthalmologische Gesellschaft (DOG), Deutsche Rheuma-Liga Bundesverband, Verein zur Förderung und Unterstützung rheumatologisch erkrankter Kinder und deren Eltern, Vereinigung für Kinderorthopädie, Zentraler Verband der Physiotherapeuten und Krankengymnasten (ZVK). Consensus conferences took place in Düsseldorf on May 9th and August 1st 2007 and were each attended by more than 95% of the nominated representatives Finally, statements were confirmed in a Delphi method.

Results and Conclusion: Consensus statements regarding drug therapy, symptomatic and surgical management of JIA were compiled and judged strictly by the criteria of Evidence-Based Medicine (EBM).

Schlüsselwörter

Juvenile Idiopathische Arthritis - evidenzbasierte Medizin - Therapieleitlinie - Kinder - Jugendliche - rheumatische Erkrankungen - Konsens

Key words

juvenile idiopathic arthritis - evidence-based medicine - treatment guideline - children - adolescence - consensus

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