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Juvenile idiopathic arthritis in the new world of biologics


  • Genevieve Tyra Ostring,

    Corresponding author
    1. The School of Medicine, Paediatrics, The University of Auckland, Auckland, New Zealand
    • Department of Paediatrics, Waitakere Hospital, Auckland, New Zealand
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  • Davinder Singh-Grewal

    1. The John Hunter Children's Hospital, Newcastle, New South Wales, Australia
    2. The Department of Rheumatology, The Sydney Children's Hospitals Network, Randwick and Westmead Campuses, Sydney, New South Wales, Australia
    3. Discipline of Paediatric and Child Health, The University of Sydney, Sydney, New South Wales, Australia
    4. School of Maternal and Child Health, The University of New South Wales, Sydney, New South Wales, Australia
    5. Department of Paediatrics, The University of Western Sydney, Sydney, New South Wales, Australia
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  • Declaration of conflict of interest: No conflict of interest.

Correspondence: Dr Genevieve Tyra Ostring, Department of Paediatrics, Waitkare Hospital, Private Bag 93115, Lincoln Road, Henderson Waitakere 0650, New Zealand. Fax: +64 9 487 152; email:


Juvenile idiopathic arthritis results in significant pain and disability in both children and adults. Advances in treatment resulting in improved long-term outcomes have occurred; however, an emphasis on early and aggressive diagnosis and management hopes to improve outcomes further. Juvenile idiopathic arthritis remains a clinical diagnosis of exclusion, but further research may delineate biological markers associated with the disease and its subtypes. Therapy for patients includes intra-articular steroid injections, disease modifying agents such as methotrexate and biological agents. Biological agents have provided exciting new therapeutic options in the last decade; however, long-term side effects of modulating the immune system are not yet fully understood. Systemic steroids may also be required but their long-term use is avoided. Uveitis needs to be screened for in all of those with the diagnosis. Multidisciplinary team care is required in managing these young people.