BACKGROUND: In 2012, a European initiative called Single Hub and Access point for
pediatric Rheumatology in Europe (SHARE) was launched to optimise and disseminate
diagnostic and management regimens in Europe for children and young adults with rheumatic
diseases. Juvenile idiopathic arthritis (JIA) is the most common rheumatic disease
in children and uveitis is possibly its most devastating extra-articular manifestation.
Evidence-based guidelines are sparse and management is mostly based on physicians'
experience. Consequently, treatment practices differ widely, within and between nations.
OBJECTIVES: To provide recommendations for the diagnosis and treatment of JIA-associated
uveitis. METHODS: Recommendations were developed by an evidence-informed consensus
process using the European League Against Rheumatism standard operating procedures.
A committee was constituted, consisting of nine experienced paediatric rheumatologists
and three experts in ophthalmology from Europe. Recommendations derived from a validated
systematic literature review were evaluated by an Expert Committee and subsequently
discussed at two consensus meetings using nominal group techniques. Recommendations
were accepted if >80% agreement was reached (including all three ophthalmologists).
RESULTS: In total, 22 recommendations were accepted (with >80% agreement among experts):
3 on diagnosis, 5 on disease activity measurements, 12 on treatment and 2 on future
recommendations. CONCLUSIONS: The SHARE initiative aims to identify best practices
for treatment of patients suffering from JIA-associated uveitis. Within this remit,
recommendations for the diagnosis and treatment of JIA-associated uveitis have been
formulated by an evidence-informed consensus process to suggest a standard of care
for JIA-associated uveitis patients throughout Europe.
