Update of evidence- and consensus-based guidelines for the treatment of juvenile idiopathic arthritis (JIA) by the German Society of Pediatric and Juvenile Rheumatic Diseases (GKJR): New perspectives on interdisciplinary care.

Background: New therapeutic strategies for juvenile idiopathic arthritis (JIA) have evolved within the past ten years, and as a result, an update of the 2011 recommendations of the German management guidelines was initiated.
Methods: A systemic literature review was performed, overarching principles were proposed and pre-selected via an online survey followed by two multidisciplinary consensus conferences. Pharmacological and non-pharmacological treatments were discussed, statements were proposed and ultimately agreed upon by nominal group technique (NGT).
Results: 12 overarching therapeutic principles, as well as 9 recommendations on pharmacological and 5 on non-pharmacological treatments for JIA were agreed upon.
Conclusion: This report summarizes the recent update of the interdisciplinary, consensus-based German guidelines on the management of JIA. The multi- and interdisciplinary participation of all caregivers was central for this patient-focused update. With these guidelines, physicians can choose an evidence-based approach, which allows better tailored treatment in this vulnerable cohort of children and adolescents.
Competing Interests: Declaration of Competing Interest Dirk Holzinger: Novartis and Sobi (speaker fees). Christoph Deuter: research support by Affibody, Panoptes, Ursapharm; AbbVie, Alimera, Amgen, Novartis, Santen, Thea, UCB (speaker fees); consulting for Alimera. Anton Hospach: SOBI, Novartis (speaker fees). Prasad T. Oommen: Novartis (speaker fees and research support). Catharina Schuetz: Novartis (research support). Norbert Wagner: GlaxoSmithKline GmbH, Sanofi-Aventis Deutschland GmbH, RG Ärztefortbildung, Ges. für Information und Organization mbH, medupdate GmbH. Tim Niehues: UptoDate.com (authorship fees), Reimbursement of travel expenses from: EMA (European Medicines Agency), PENTA (Pediatric European Network for Treatment of AIDS), JIR (Juvenile Inflammatory Cohort). Michael Wachowsky: Biomarin Germany, Nuvasive Germany (reimbursement of travel expenses). Klaus Tenbrock: Novartis foundation, Pfizer (IIT), MBS (IIT) (research grants); Advisory Board for Novartis, Pfizer, GSK. Ariane Klein: Pfizer (speaker fees). Claas Hinze: Pfizer (reimbursement of travel expenses), Novartis (advisory board). Michael Jung: AquaFitness Akademie Hanau (consultancy). Ivan Foeldvari: Novartis, hexal, Medac, Lilly, Pfizer (advisory boards). Kirsten Minden: Pfizer, Novartis (consultancy), Abbvie, Novartis, Pfizer, Roche, Initiative for the child with rheumatism (speaker fees); Medac (honoraria). Tilmann Kallinich: Roche (speaker fees). Karen Baltruschat, Gerd Ganser, Johannes-Peter Haas, Hans-Iko Huppertz, Arnold Illhardt, Kirsten Mönkemöller, Sonja Mrusek, Ulrich Neudorf, Gregor Dückers, Matthias Schneider, Philipp Schoof, Angelika Thon, Susanne Bloedt, Michael Hofer declare no conflict of interest.
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