The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Juvenile Idiopathic Arthritis (JIA): Polyarticular Course JIA, Temporomandibular Joint Arthritis, Imaging, and Non-Pharmacologic Therapies
Issued Date
2026-04-01
Resource Type
ISSN
17561841
eISSN
1756185X
Scopus ID
2-s2.0-105035595551
Journal Title
International Journal of Rheumatic Diseases
Volume
29
Issue
4
Rights Holder(s)
SCOPUS
Bibliographic Citation
International Journal of Rheumatic Diseases Vol.29 No.4 (2026)
Suggested Citation
Arkachaisri T., Teh K.L., Vilaiyuk S., Al-Mayouf S.M., Tang S.P., Miyamae T., Ang E.Y., Ziaee V., Bagri N.K., Balan S., Bernal C.B., Chan W.K.Y., Charuvanij S., Campbell-Stokes P., Ho A.C.H., Jagoda J.S., James R.A., Khaliq T., Khan S.E.A., Tee C.A., Wu C.Y., Asis C.M., Asnaashari K., Chan P., Celindro-Chan M.C.M., Choi N.G.U., Collante M.T., Huang J., Lim S.C., Lebrudo M.J.H., Lerkvaleekul B., Sontichai W., Valmonte M.B., Dans L.F., Farman S. The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Juvenile Idiopathic Arthritis (JIA): Polyarticular Course JIA, Temporomandibular Joint Arthritis, Imaging, and Non-Pharmacologic Therapies. International Journal of Rheumatic Diseases Vol.29 No.4 (2026). doi:10.1111/1756-185x.70640 Retrieved from: https://repository.li.mahidol.ac.th/handle/123456789/116273
Title
The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Juvenile Idiopathic Arthritis (JIA): Polyarticular Course JIA, Temporomandibular Joint Arthritis, Imaging, and Non-Pharmacologic Therapies
Author(s)
Arkachaisri T.
Teh K.L.
Vilaiyuk S.
Al-Mayouf S.M.
Tang S.P.
Miyamae T.
Ang E.Y.
Ziaee V.
Bagri N.K.
Balan S.
Bernal C.B.
Chan W.K.Y.
Charuvanij S.
Campbell-Stokes P.
Ho A.C.H.
Jagoda J.S.
James R.A.
Khaliq T.
Khan S.E.A.
Tee C.A.
Wu C.Y.
Asis C.M.
Asnaashari K.
Chan P.
Celindro-Chan M.C.M.
Choi N.G.U.
Collante M.T.
Huang J.
Lim S.C.
Lebrudo M.J.H.
Lerkvaleekul B.
Sontichai W.
Valmonte M.B.
Dans L.F.
Farman S.
Teh K.L.
Vilaiyuk S.
Al-Mayouf S.M.
Tang S.P.
Miyamae T.
Ang E.Y.
Ziaee V.
Bagri N.K.
Balan S.
Bernal C.B.
Chan W.K.Y.
Charuvanij S.
Campbell-Stokes P.
Ho A.C.H.
Jagoda J.S.
James R.A.
Khaliq T.
Khan S.E.A.
Tee C.A.
Wu C.Y.
Asis C.M.
Asnaashari K.
Chan P.
Celindro-Chan M.C.M.
Choi N.G.U.
Collante M.T.
Huang J.
Lim S.C.
Lebrudo M.J.H.
Lerkvaleekul B.
Sontichai W.
Valmonte M.B.
Dans L.F.
Farman S.
Author's Affiliation
Chinese University of Hong Kong
Tehran University of Medical Sciences
All India Institute of Medical Sciences, New Delhi
Chang Gung Memorial Hospital
Universiti Teknologi MARA
Tokyo Women's Medical University
Siriraj Hospital
National University Health System
University of the Philippines Diliman
University of the Philippines Manila
Faculty of Medicine Ramathibodi Hospital, Mahidol University
KK Women's And Children's Hospital
Amrita Institute of Medical Sciences India
Kementerian Kesihatan Malaysia
Queen Elizabeth Hospital Hong Kong
Children's Medical Center (TUMS)
College of Medicine Alfaisal University
Philippine General Hospital
Children’s Health Queensland
Faculty of Medicine, Thammasat University
University of the Philippines College of Medicine
St. Luke's Medical Center Quezon City
University of Santo Tomas Hospital
Manila Doctors Hospital
Federal Government Polyclinic Hospital
Shalamar Hospital
Health New Zealand
Lady Ridgeway Hospital
National Hospital Postgraduate Training & Medical Center
Tehran University of Medical Sciences
All India Institute of Medical Sciences, New Delhi
Chang Gung Memorial Hospital
Universiti Teknologi MARA
Tokyo Women's Medical University
Siriraj Hospital
National University Health System
University of the Philippines Diliman
University of the Philippines Manila
Faculty of Medicine Ramathibodi Hospital, Mahidol University
KK Women's And Children's Hospital
Amrita Institute of Medical Sciences India
Kementerian Kesihatan Malaysia
Queen Elizabeth Hospital Hong Kong
Children's Medical Center (TUMS)
College of Medicine Alfaisal University
Philippine General Hospital
Children’s Health Queensland
Faculty of Medicine, Thammasat University
University of the Philippines College of Medicine
St. Luke's Medical Center Quezon City
University of Santo Tomas Hospital
Manila Doctors Hospital
Federal Government Polyclinic Hospital
Shalamar Hospital
Health New Zealand
Lady Ridgeway Hospital
National Hospital Postgraduate Training & Medical Center
Corresponding Author(s)
Other Contributor(s)
Abstract
Background: Juvenile idiopathic arthritis (JIA) is one of the most common childhood rheumatic diseases. In the Asia-Pacific region, access to pediatric rheumatology services and therapies remains variable. To address regional disparities and promote evidence-based yet practical care, the APLAR developed consensus recommendations for the management of polyarticular-course JIA (pcJIA), temporomandibular joint (TMJ) arthritis, and non-pharmacologic interventions. Methods: A multidisciplinary task force of 34 members from 14 countries, including pediatric and adult rheumatologists and patient representatives, was convened. The guideline development followed the GRADE, ADAPTE, and AGREE II frameworks. Existing international guidelines were critically appraised, and a systematic literature review was performed to address 26 PICO questions. Draft statements were discussed and voted upon using a modified Delphi process, with consensus defined as ≥ 80% agreement. Results: Four overarching principles and 32 statements were finalized: 16 for pcJIA treatment, 10 for TMJ arthritis, 3 for non-pharmacologic therapies, 2 for imaging, and 1 for disease monitoring. Key recommendations that diverge from Western guidelines include: (1) stronger recommendation for methotrexate as initial therapy before biologic DMARDs; (2) explicit advocacy for TNF inhibitors, including biosimilars, when escalation is required; (3) cautious allowance of short-term systemic glucocorticoids where DMARDs are limited; (4) emphasis on treat-to-target using cJADAS-10; (5) stronger endorsement for physical and occupational therapy; and (6) conditional allowance of traditional and complementary medicine practices under professional supervision. Conclusion: These consensus statements provide regionally adapted, evidence-based recommendations to improve access, standardize management, and promote equitable care for patients with JIA across the Asia-Pacific region.