Progress in pediatric rheumatology: Apprehend the opportunities of the future without forgetting the lessons from the past

Abstract

Investigators mainly from North America have established a new classiWcation of juvenile idiopathic arthritis (JIA) by creating treatment groups, levels of disease activity and prognostic features [3]. After scanning the available litera ture for controlled trials the authors recommend treatment options. Due to the lack of published evidence these authors could not Wnd an indication for the use of systemic steroids in chronic synovitis. Since this drug may be very useful for patients with JIA and its introduction predates evidence-based medicine, it should not be removed from treatment algorithms, but should be tested in controlled trials. Further topics of discussion relate to treatment with tocilizumab, rituximab, methotrexate, hydroxychloroquine, abatacept and to varying levels of evidence in treatment recommendations. Beukelman et al. will have a lasting impact on the treatment of JIA. European Societies for Pediatric Rheumatology should participate in future developments. © Springer-Verlag 2010.