Structured Abstract

Contents

• Preface
• Technical Expert Panel
• Peer Reviewers
• Executive Summary
• Introduction
  • Background
  • Scope and Key Questions
• Methods
  • Topic Refinement
  • Search Strategy
  • Study Selection
  • Analytic Framework
  • Data Extraction
  • Quality Assessment
  • Rating the Body of Evidence
  • Assessing Applicability
  • Data Synthesis
  • Peer Review Process
• Results
  • Literature Search and Screening
  • Key Question 1 In children with JIA, does treatment with DMARDs, compared to conventional treatment, improve laboratory measures of inflammation or radiological progression, symptoms (e.g., pain, symptom scores), or health status (e.g., functional ability, mortality)?
  • Key Question 2 In children with JIA, what are the comparative effects of DMARDs on laboratory markers of inflammation or radiological progression, symptoms (e.g., pain, symptom scores), or health status (e.g., functional ability, mortality)?
  • Key Question 3 In children with JIA, does the rate and type of adverse events differ between the various DMARDs or between DMARDs and conventional treatment with or without methotrexate?
  • Key Question 4 How do the efficacy, effectiveness, safety, and adverse effects of treatment with DMARDs differ among the various categories of JIA?
  • Key Question 5 What are the validity, reliability, responsiveness, and feasibility of the clinical outcomes measures for childhood JIA that are commonly used in clinical trials or within the clinical practice setting?
• Summary and Discussion
• Future Research
  • Efficacy of DMARDs
  • Safety of DMARDs
  • Impact of DMARDs on Health Outcomes
• References
• Abbreviations
• Appendixes
  • Appendix A Exact Search Strings
  • Appendix B Screening Criteria
  • Appendix C Data Abstraction Forms
  • Appendix D Evidence Tables—Main Literature Search
  • Appendix E Adverse Events—Wider Literature Search
  • Appendix F Excluded Studies

Prepared for: Agency for Healthcare Research and Quality, U.S. Department of Health and Human Services¹, Contract No. 290-2007-10066-I. Prepared by: Duke Evidence-based Practice Center, Durham, NC.

Suggested citation:

Kemper AR, Coeytaux R, Sanders GD, Van Mater H, Williams JW, Gray RN, Irvine RJ, Kendrick A. Disease-Modifying Antirheumatic Drugs (DMARDs) in Children With Juvenile Idiopathic Arthritis (JIA). Comparative Effectiveness Review No. 28. (Prepared by the Duke Evidence-based Practice Center under Contract No. 290-2007-10066-I.) AHRQ Publication No. 11-EHC039-EF. Rockville, MD: Agency for Healthcare Research and Quality. September 2011. Available at:www.effectivehealthcare.ahrq.gov/reports/final.cfm.

This report is based on research conducted by the Duke Evidence-based Practice Center under contract to the Agency for Healthcare Research and Quality (AHRQ), Rockville, MD (Contract No. 290-2007-10066-I). The findings and conclusions in this document are those of the author(s), who are responsible for its content, and do not necessarily represent the views of AHRQ. No statement in this report should be construed as an official position of AHRQ or of the U.S. Department of Health and Human Services.

The information in this report is intended to help clinicians, employers, policymakers, and others make informed decisions about the provision of health care services. This report is intended as a reference and not as a substitute for clinical judgment.

This report may be used, in whole or in part, as the basis for the development of clinical practice guidelines and other quality enhancement tools, or as a basis for reimbursement and coverage policies. AHRQ or U.S. Department of Health and Human Services endorsement of such derivative products or actions may not be stated or implied.

None of the investigators has any affiliations or financial involvement that conflicts with the material presented in this report.

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