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. 2018 Aug;77(8):1107-1117.
doi: 10.1136/annrheumdis-2018-213131. Epub 2018 Mar 28.

Consensus-based recommendations for the management of uveitis associated with juvenile idiopathic arthritis: the SHARE initiative

Tamas Constantin  1 , Ivan Foeldvari  2 , Jordi Anton  3 , Joke de Boer  4 , Severine Czitrom-Guillaume  5 , Clive Edelsten  6 , Raz Gepstein  7 , Arnd Heiligenhaus  8   9 , Clarissa A Pilkington  10 , Gabriele Simonini  11 , Yosef Uziel  12 , Sebastian J Vastert  13 , Nico M Wulffraat  13 , Anne-Mieke Haasnoot  4 , Karoline Walscheid  8 , Annamária Pálinkás  1 , Reshma Pattani  6 , Zoltán Györgyi  1 , Richárd Kozma  1 , Victor Boom  14 , Andrea Ponyi  1 , Angelo Ravelli  15 , Athimalaipet V Ramanan  16
Affiliations

Consensus-based recommendations for the management of uveitis associated with juvenile idiopathic arthritis: the SHARE initiative

Tamas Constantin et al. Ann Rheum Dis. 2018 Aug.

Abstract

Background: In 2012, a European initiative called Single Hub and Access point for pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate diagnostic and management regimens in Europe for children and young adults with rheumatic diseases. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is possibly its most devastating extra-articular manifestation. Evidence-based guidelines are sparse and management is mostly based on physicians' experience. Consequently, treatment practices differ widely, within and between nations.

Objectives: To provide recommendations for the diagnosis and treatment of JIA-associated uveitis.

Methods: Recommendations were developed by an evidence-informed consensus process using the European League Against Rheumatism standard operating procedures. A committee was constituted, consisting of nine experienced paediatric rheumatologists and three experts in ophthalmology from Europe. Recommendations derived from a validated systematic literature review were evaluated by an Expert Committee and subsequently discussed at two consensus meetings using nominal group techniques. Recommendations were accepted if >80% agreement was reached (including all three ophthalmologists).

Results: In total, 22 recommendations were accepted (with >80% agreement among experts): 3 on diagnosis, 5 on disease activity measurements, 12 on treatment and 2 on future recommendations.

Conclusions: The SHARE initiative aims to identify best practices for treatment of patients suffering from JIA-associated uveitis. Within this remit, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated by an evidence-informed consensus process to suggest a standard of care for JIA-associated uveitis patients throughout Europe.

Keywords: Tnf-alpha; juvenile idiopathic arthritis; methotrexate.

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Conflict of interest statement

Competing interests: AH: research grants from BMBF, Pfizer and Novartis and honoraria from AbbVie, Alimera Sciences, Allergan, MSD Sharp and Dohme, Pfizer, Santen, and Xoma. JdB: lectures and advisory board sponsored by AbbVie. SC-G: Pfizer, occasional consulting and registration fees to EULAR/PReS congress and Novartis, registration fees for PReS. IF: advisory board: Abbvie, Novartis, Chugai, Lilly, Medac, Genentech, Bayer. CE: Abbvie: receipt of honoraria and travel expenses. JA has received research grants, speakers bureau or has participated in advisory groups for Abbvie, Pfizer, Roche and BMS. CAP, educational sponsorship from Abbvie. AVR, co-chief investigator of Sycamore Study (funded by NIHR and ARUK). Honoraria/speaker fees from Abbvie, Roche, Lily, UCB and SOBI.

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