The importance of transition from pediatric to adult rheumatology care in juvenile idiopathic arthritis.
Rodrigo Joel de OliveiraSimone Thiemi KishimotoDébora Pessoa de SouzaPaula Teixeira FernandesRoberto MariniSimone AppenzellerPublished in: Expert review of clinical immunology (2021)
Introduction: Juvenile idiopathic arthritis (JIA) is the most common rheumatic inflammatory condition in childhood. The long-term morbidity, mortality, and quality of life have improved with the earlier use of disease-modifying drugs (DMARDs) and the availability of biology disease-modifying drugs (bDMARDs). Despite the improvement of treatment, around 50% of the patients reach adulthood with articular and/or extra articular disease activity. A careful planned transition from pediatric to adult care is necessary to reduce the loss of follow-up that is associated with stopping medications, flares, and disability due to untreated arthritis or uveitis.Areas covered: This narrative review provides an overview of the importance of transition in JIA Articles were selected from Pubmed searches.Expert opinion: JIA patients, family, and healthcare workers have to be trained to provide an effective transition plan, based on local and national policies. Important aspects such as expectations, maturation, disease characteristics, disease activity, adherence, disability, and psychological aspects among others have to be considered and addressed during the transition phase to improve self-esteem, self-assurance, and quality of life.
Keyphrases
- juvenile idiopathic arthritis
- disease activity
- rheumatoid arthritis
- systemic lupus erythematosus
- rheumatoid arthritis patients
- ankylosing spondylitis
- end stage renal disease
- healthcare
- ejection fraction
- chronic kidney disease
- newly diagnosed
- multiple sclerosis
- quality improvement
- palliative care
- cardiovascular disease
- public health
- peritoneal dialysis
- clinical practice
- oxidative stress
- combination therapy
- coronary artery disease
- metabolic syndrome
- adipose tissue
- young adults
- early life
- sleep quality
- affordable care act
- replacement therapy