The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)

The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease) Publisher Pubmed

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 Show All Authors

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

Source: International Journal of Rheumatic Diseases Published:2026

Abstract

Background: The unique characteristics of the Asia Pacific called for the development of pragmatic and viable guidelines for the management of juvenile idiopathic arthritis (JIA). These consensus recommendations represent the second part of the guideline intending to offer an updated and regionally relevant framework for the management of systemic JIA (sJIA)/juvenile Still's disease. Methods: A multidisciplinary task force of 35 members from 14 countries, including pediatric and adult rheumatologists as well as patient representatives, was convened. The guideline development followed the GRADE, ADAPTE, and AGREE II frameworks. Relevant international guidelines were critically appraised, and a systematic literature review was performed to address 10 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 eighteen statements, including five statements addressing macrophage activation syndrome (MAS) were formulated. The recommendations align with international guidelines, advocating early use of IL-1/IL-6 inhibitors, avoidance of glucocorticoid monotherapy in sJIA without MAS, promoting tapering of glucocorticoids once inactive disease is achieved, alongside class switching for biologic refractory cases and a treat-to-target approach akin to EULAR/PReS guideline. Additional features include recommending conventional synthetic DMARD when biologics are unavailable and listing the options, acknowledging regional health system heterogeneity in the Asia Pacific, mentioning tapering strategy, discouraging NSAIDs as initial monotherapy, highlighting non-biologic salvage options, and placing less emphasis on sJIA-associated lung diseases. Conclusion: These recommendations provide direction for practitioners caring for sJIA patients in limited resource areas to avoid treatment delay, hence improve overall outcomes. A shared decision approach and treat-to-targets are emphasized. © 2026 Asia Pacific League of Associations for Rheumatology and John Wiley & Sons Australia, Ltd.

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Style	Citing Format
MLA	Arkachaisri T, et al.. "The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)." International Journal of Rheumatic Diseases, vol. 29, no. 8, 2026, pp. -.
APA	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, ... Farman S (2026). The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease). International Journal of Rheumatic Diseases, 29(8), -.
Chicago	Arkachaisri T, Teh K L, Vilaiyuk S, Al Mayouf S M, Tang S P, Miyamae T, Ang E Y, et al.. "The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)." International Journal of Rheumatic Diseases 29, no. 8 (2026): -.
Harvard	Arkachaisri T et al. (2026) 'The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)', International Journal of Rheumatic Diseases, 29(8), pp. -.
Vancouver	Arkachaisri T, Teh K L, Vilaiyuk S, Al Mayouf S M, Tang S P, Miyamae T, et al.. The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease). International Journal of Rheumatic Diseases. 2026;29(8):-.
BibTex	@article{ author = {Arkachaisri T and Teh K L and Vilaiyuk S and Al Mayouf S M and Tang S P and Miyamae T and Ang E Y and Ziaee V and Bagri N K and Balan S and Bernal C B and Chan W K Y and Charuvanij S and Campbell Stokes P and Ho A C H and Jagoda J S and James R A and Khaliq T and Khan S E A and Tee C A and Wu C Y and Asis C M and Asnaashari K and Chan P and Celindro Chan M C M and Choi N G U and Collante M T and Huang J and Lim S C and Lebrudo M J H and Lerkvaleekul B and Sontichai W and Valmonte M B and Dans L F and Farman S}, title = {The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)}, journal = {International Journal of Rheumatic Diseases}, volume = {29}, number = {8}, pages = {-}, year = {2026} }
RIS	TY - JOUR AU - Arkachaisri T AU - Teh K L AU - Vilaiyuk S AU - Al Mayouf S M AU - Tang S P AU - Miyamae T AU - Ang E Y AU - Ziaee V AU - Bagri N K AU - Balan S AU - Bernal C B AU - Chan W K Y AU - Charuvanij S AU - Campbell Stokes P AU - Ho A C H AU - Jagoda J S AU - James R A AU - Khaliq T AU - Khan S E A AU - Tee C A AU - Wu C Y AU - Asis C M AU - Asnaashari K AU - Chan P AU - Celindro Chan M C M AU - Choi N G U AU - Collante M T AU - Huang J AU - Lim S C AU - Lebrudo M J H AU - Lerkvaleekul B AU - Sontichai W AU - Valmonte M B AU - Dans L F AU - Farman S TI - The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease) JO - International Journal of Rheumatic Diseases VL - 29 IS - 8 SP - EP - PY - 2026 ER -

Style

Citing Format

MLA

Arkachaisri T, et al.. "The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)." International Journal of Rheumatic Diseases, vol. 29, no. 8, 2026, pp. -.

APA

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, ... Farman S (2026). The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease). International Journal of Rheumatic Diseases, 29(8), -.

Chicago

Arkachaisri T, Teh K L, Vilaiyuk S, Al Mayouf S M, Tang S P, Miyamae T, Ang E Y, et al.. "The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)." International Journal of Rheumatic Diseases 29, no. 8 (2026): -.

Harvard

Arkachaisri T et al. (2026) 'The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)', International Journal of Rheumatic Diseases, 29(8), pp. -.

Vancouver

Arkachaisri T, Teh K L, Vilaiyuk S, Al Mayouf S M, Tang S P, Miyamae T, et al.. The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease). International Journal of Rheumatic Diseases. 2026;29(8):-.

BibTex

@article{ author = {Arkachaisri T and Teh K L and Vilaiyuk S and Al Mayouf S M and Tang S P and Miyamae T and Ang E Y and Ziaee V and Bagri N K and Balan S and Bernal C B and Chan W K Y and Charuvanij S and Campbell Stokes P and Ho A C H and Jagoda J S and James R A and Khaliq T and Khan S E A and Tee C A and Wu C Y and Asis C M and Asnaashari K and Chan P and Celindro Chan M C M and Choi N G U and Collante M T and Huang J and Lim S C and Lebrudo M J H and Lerkvaleekul B and Sontichai W and Valmonte M B and Dans L F and Farman S}, title = {The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)}, journal = {International Journal of Rheumatic Diseases}, volume = {29}, number = {8}, pages = {-}, year = {2026} }

RIS

TY - JOUR
AU - Arkachaisri T
AU - Teh K L
AU - Vilaiyuk S
AU - Al Mayouf S M
AU - Tang S P
AU - Miyamae T
AU - Ang E Y
AU - Ziaee V
AU - Bagri N K
AU - Balan S
AU - Bernal C B
AU - Chan W K Y
AU - Charuvanij S
AU - Campbell Stokes P
AU - Ho A C H
AU - Jagoda J S
AU - James R A
AU - Khaliq T
AU - Khan S E A
AU - Tee C A
AU - Wu C Y
AU - Asis C M
AU - Asnaashari K
AU - Chan P
AU - Celindro Chan M C M
AU - Choi N G U
AU - Collante M T
AU - Huang J
AU - Lim S C
AU - Lebrudo M J H
AU - Lerkvaleekul B
AU - Sontichai W
AU - Valmonte M B
AU - Dans L F
AU - Farman S
TI - The Asia-Pacific League of Associations for Rheumatology Consensus Recommendations on the Management of Systemic Juvenile Idiopathic Arthritis (Juvenile Still's Disease)
JO - International Journal of Rheumatic Diseases
VL - 29
IS - 8
SP -
EP -
PY - 2026
ER -

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