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Recommendations for the Management of Uveitis Associated With Juvenile Idiopathic Arthritis: The Czech and Slovak adaptation of SHARE Initiative


Authors: H. Malcová 1;  T. Dallos 2;  K. Bouchalova 3;  I. Brejchová 4;  M. Brichová 5;  B. Bušányová 6;  J. Fabianová 7;  J. Fráňová 8;  A. Furdová 9;  K. Jarošová 10;  K. Kobrová 11;  B. Kostolná 6;  E. Košková 12;  M. Lokaj 13;  M. Macků 8;  J. Melocíková 14;  M. Michaličková 5;  L. Minxová 15;  D. Moravčíková 14;  D. Němcová 16;  T. Pískovský 17;  E. Říhová 5;  M. Schüller 7;  E. Skalická 18;  P. Svozílková 5;  D. Tomčíková 6;  V. Vargová 19;  E. Vrtíková 12;  P. Doležalová 16;  prof. MUDr. Jarmila Heissigerová, Ph.D., MBA 5
Authors place of work: Oddělení revmatologie dětí a dospělých, Fakultní nemocnice v Motole, Praha, ČR 1;  Detská klinika LF UK v Bratislave a NÚDCH, Bratislava, SR 2;  Dětská klinika, LF UP a FN Olomouc, ČR 3;  Nemocnice České Budějovice, ČR 4;  Oční klinika VFN a 1. LF UK, Praha, ČR 5;  Klinika detskej oftalmológie LF UK a NÚDCH, Bratislava, SR 6;  NUTPCHaHCH Vyšné Hágy I, Vysoké Tatry, SR 7;  Pediatrická klinika LF MU a FN Brno, ČR 8;  Očná klinika LFUK v Bratislave a UNB, Bratislava, SR 9;  Revmatologický ústav, Praha, ČR 10;  Dětská klinika Masarykovy nemocnice, Ústí nad Labem, ČR 11;  Národný ústav reumatických chorôb, Piešťany, SR 12;  Dětská oční klinika LF MU a FN Brno, ČR 13;  II. detská klinika SZU DFNsP, Banská Bystrica, SR 14;  Dětská klinika LF UK a FN Hradec Králové, ČR 15;  Klinika dětského a dorostového lékařství 1. LF UK a VFN v Praze, ČR 16;  Klinika dětského lékařství, Fakultní nemocnice Ostrava, ČR 17;  Dětská klinika LF UK a FN Plzeň, ČR 18;  Klinika detí a dorastu, LF UPJŠ Košice, SR 19
Published in the journal: Čes. a slov. Oftal., 76, 2020, No. 4, p. 182-196
Category:
doi: https://doi.org/10.31348/2020/7

Summary

Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease in children and uveitis is its most important extra-articular manifestation. Evidence-based recommendations are available only to a limited extent and therefore JIA associated uveitis management is mostly based on physicians’ experience. Consequently, treatment practices differ widely, both nationally and internationally. Therefore, an effort to optimize and publish recommendations for the care of children and young adults with rheumatic diseases was launched in 2012 as part of the international project SHARE (Single Hub and Access Point for Pediatric Rheumatology in Europe) to facilitate clinical practice for paediatricians and (paediatric) rheumatologists.

The aim of this work was to translate published international SHARE recommendations for the diagnosis and treatment of JIA associated uveitis and to adapt them for use in the Czech and Slovak Republics.

International recommendations were developed according to the standard methodology of the European League against Rheumatism (EULAR) by a group of nine experienced paediatric rheumatologists and three experts in ophthalmology. It was based on a systematic literature review and evaluated in the form of an online survey and subsequently discussed using a nominal group technique. Recommendations were accepted if 
> 80% agreement was reached (including all three ophthalmologists).

A total of 22 SHARE recommendations were accepted: 3 on diagnosis, 5 on disease activity assessment, 12 on treatment and 2 on future recommendations. Translation of the original text was updated and modified with data specific to the czech and slovak health care systems and supplemented with a proposal for a protocol of ophthalmological dispensarization of paediatric JIA patients and a treatment algorithm for JIA associated uveitis.

Conclusion: The aim of the SHARE initiative is to improve and standardize care for paediatric patients with rheumatic diseases across Europe. Therefore, recommendations for the diagnosis and treatment of JIA-associated uveitis have been formulated based on the evidence and agreement of leading European experts in this field.

Keywords:

recommendation – juvenile idiopathic arthritis (JIA) – Uveitis


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