Considerable variability exists in how patients with pediatric rheumatic diseases are treated in clinical practice, making it hard to determine which therapies work best, a new review study says. This highlights the need for more standardized treatments.
Pediatric rheumatic diseases, including juvenile arthritis, are a rare group of diseases that have proven challenging in both clinical and research settings. This is mainly because traditional clinical trials involving placebo controls are difficult to perform due to the low numbers of patients.
The study, “The Childhood Arthritis & Rheumatology Research Alliance Consensus Treatment Plans: Towards Comparative Effectiveness in the Pediatric Rheumatic Diseases,” published in the journal Arthritis and Rheumatology, reviewed the current status of the field to address these challenges.
The Childhood Arthritis and Rheumatology Research Alliance (CARRA), the largest pediatric rheumatology research collaboration in North America, has developed treatment strategies based on consensus methods among expert CARRA members to reduce treatment variability and allow different therapeutic approaches to be compared.
The strategies are referred to as the consensus treatment plan (CTP), and CARRA is pioneering its use to standardize treatments for pediatric rheumatic diseases.
CTPs currently exist for seven diseases, including systemic onset juvenile idiopathic arthritis (JIA), polyarticular JIA, juvenile localized scleroderma, dermatomyositis, and lupus nephritis.
According to a press release, the lead author of the review study, Sarah Ringold, MD, MS, from Seattle Children’s Hospital, summarizes the approach by saying, “[O]nce a diagnosis is made, providers and patients and their families can choose together the CTP strategy that they believe will work the best for that disease. Information on how the patient is doing on that treatment is then collected at regular clinic visits through a registry. At the end of the proposed study duration, researchers can then compare how the patients do between the different CTPs.”
Large-scale studies are currently underway to test CTP strategies in the treatment of these rare pediatric diseases.