{"id":"https://openalex.org/W7225201369","doi":"https://doi.org/10.1093/rap/rkag113.022","title":"OA22 Juvenile idiopathic arthritis in transition: From childhood remission to difficult-to-treat adult disease","display_name":"OA22 Juvenile idiopathic arthritis in transition: From childhood remission to difficult-to-treat adult disease","publication_year":2026,"publication_date":"2026-11-01","ids":{"openalex":"https://openalex.org/W7225201369","doi":"https://doi.org/10.1093/rap/rkag113.022"},"language":"en","primary_location":{"id":"doi:10.1093/rap/rkag113.022","doi":"https://doi.org/10.1093/rap/rkag113.022","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.022","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"volume":null,"type":"conference-abstract","is_traditional":false,"indexed_in":["crossref","doaj"],"open_access":{"is_oa":true,"oa_status":"gold","oa_url":"https://doi.org/10.1093/rap/rkag113.022","any_repository_has_fulltext":true},"authorships":[{"author_position":"first","author":{"id":"https://openalex.org/A5116065411","display_name":"Krishna Dasigan","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801663869","display_name":"Newcastle upon Tyne Hospitals NHS Foundation Trust","ror":"https://ror.org/05p40t847","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801663869"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Krishna Dasigan","raw_affiliation_strings":["The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,","institution_ids":["https://openalex.org/I2801663869"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5017887525","display_name":"Najla Elndari","orcid":"https://orcid.org/0009-0003-5686-9071","observed_orcids":["https://orcid.org/0009-0003-5686-9071"]},"institutions":[{"id":"https://openalex.org/I2801663869","display_name":"Newcastle upon Tyne Hospitals NHS Foundation Trust","ror":"https://ror.org/05p40t847","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801663869"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Najla Elndari","raw_affiliation_strings":["The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,","institution_ids":["https://openalex.org/I2801663869"]}]},{"author_position":"middle","author":{"id":"https://openalex.org/A5134781083","display_name":"Hassan Butt","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801663869","display_name":"Newcastle upon Tyne Hospitals NHS Foundation Trust","ror":"https://ror.org/05p40t847","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801663869"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Hassan Butt","raw_affiliation_strings":["The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Newcastle upon Tyne Hospitals NHS Foundation Trust , Newcastle-upon-Tyne,","institution_ids":["https://openalex.org/I2801663869"]}]},{"author_position":"last","author":{"id":"https://openalex.org/A5030874367","display_name":"Rihards Buss","orcid":null,"observed_orcids":[]},"institutions":[{"id":"https://openalex.org/I2801663869","display_name":"Newcastle upon Tyne Hospitals NHS Foundation Trust","ror":"https://ror.org/05p40t847","country_code":"GB","type":"healthcare","lineage":["https://openalex.org/I2801663869"]}],"countries":["GB"],"is_corresponding":false,"raw_author_name":"Rihards Buss","raw_affiliation_strings":["The Newcastle upon Tyne Hospitals NHS Foundation Trust, The Newcastle upon Tyne Hospitals NHS Foundation Trust ,"],"raw_orcid":null,"affiliations":[{"raw_affiliation_string":"The Newcastle upon Tyne Hospitals NHS Foundation Trust, The Newcastle upon Tyne Hospitals NHS Foundation Trust ,","institution_ids":["https://openalex.org/I2801663869"]}]}],"institutions":[],"countries_distinct_count":1,"institutions_distinct_count":1,"corresponding_author_ids":[],"corresponding_institution_ids":["https://openalex.org/I2801663869"],"apc_list":{"value":2255,"currency":"GBP","value_usd":2974},"apc_paid":{"value":2255,"currency":"GBP","value_usd":2974},"fwci":null,"has_fulltext":true,"cited_by_count":0,"citation_normalized_percentile":null,"cited_by_percentile_year":null,"biblio":{"volume":"10","issue":"Supplement_1","first_page":null,"last_page":null},"is_retracted":false,"is_paratext":false,"is_xpac":false,"primary_topic":{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.9771000146865845,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},"topics":[{"id":"https://openalex.org/T11616","display_name":"Autoimmune and Inflammatory Disorders Research","score":0.9771000146865845,"subfield":{"id":"https://openalex.org/subfields/2720","display_name":"Hematology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T12823","display_name":"Adolescent and Pediatric Healthcare","score":0.014499999582767487,"subfield":{"id":"https://openalex.org/subfields/2735","display_name":"Pediatrics, Perinatology and Child Health"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}},{"id":"https://openalex.org/T10200","display_name":"Rheumatoid Arthritis Research and Therapies","score":0.00430000014603138,"subfield":{"id":"https://openalex.org/subfields/2745","display_name":"Rheumatology"},"field":{"id":"https://openalex.org/fields/27","display_name":"Medicine"},"domain":{"id":"https://openalex.org/domains/4","display_name":"Health Sciences"}}],"keywords":[{"id":"https://openalex.org/keywords/juvenile-idiopathic-arthritis","display_name":"juvenile idiopathic arthritis","score":0.9769999980926514},{"id":"https://openalex.org/keywords/transition-to-adult-care","display_name":"transition to adult care","score":0.6710000038146973},{"id":"https://openalex.org/keywords/polyarticular-disease","display_name":"polyarticular disease","score":0.5809999704360962},{"id":"https://openalex.org/keywords/treatment-refractory-arthritis","display_name":"treatment-refractory arthritis","score":0.7770000100135803},{"id":"https://openalex.org/keywords/biological-therapy","display_name":"biologic therapy","score":0.5759999752044678},{"id":"https://openalex.org/keywords/glucocorticoid-dependence","display_name":"glucocorticoid dependence","score":0.8090000152587891},{"id":"https://openalex.org/keywords/methotrexate-intolerance","display_name":"methotrexate intolerance","score":0.6759999990463257},{"id":"https://openalex.org/keywords/anterior-uveitis","display_name":"anterior uveitis","score":0.6520000100135803},{"id":"https://openalex.org/keywords/recurrence","display_name":"recurrence","score":0.5849999785423279},{"id":"https://openalex.org/keywords/certolizumab","display_name":"certolizumab","score":0.6449999809265137},{"id":"https://openalex.org/keywords/tocilizumab","display_name":"tocilizumab","score":0.7979999780654907}],"concepts":[{"id":"https://openalex.org/C71924100","wikidata":"https://www.wikidata.org/wiki/Q11190","display_name":"Medicine","level":0,"score":0.9623000025749207},{"id":"https://openalex.org/C2780132546","wikidata":"https://www.wikidata.org/wiki/Q348260","display_name":"Adalimumab","level":3,"score":0.629800021648407},{"id":"https://openalex.org/C2781059491","wikidata":"https://www.wikidata.org/wiki/Q422232","display_name":"Methotrexate","level":2,"score":0.6008999943733215},{"id":"https://openalex.org/C2776194053","wikidata":"https://www.wikidata.org/wiki/Q280027","display_name":"Uveitis","level":2,"score":0.5852000117301941},{"id":"https://openalex.org/C2777077863","wikidata":"https://www.wikidata.org/wiki/Q170990","display_name":"Arthritis","level":2,"score":0.585099995136261},{"id":"https://openalex.org/C2779134260","wikidata":"https://www.wikidata.org/wiki/Q12136","display_name":"Disease","level":2,"score":0.48829999566078186},{"id":"https://openalex.org/C187212893","wikidata":"https://www.wikidata.org/wiki/Q123028","display_name":"Pediatrics","level":1,"score":0.46540001034736633},{"id":"https://openalex.org/C198451711","wikidata":"https://www.wikidata.org/wiki/Q327657","display_name":"Rheumatology","level":2,"score":0.45570001006126404},{"id":"https://openalex.org/C2776715498","wikidata":"https://www.wikidata.org/wiki/Q11426176","display_name":"Prednisolone","level":2,"score":0.439300000667572},{"id":"https://openalex.org/C2777138892","wikidata":"https://www.wikidata.org/wiki/Q415264","display_name":"Infliximab","level":3,"score":0.38989999890327454},{"id":"https://openalex.org/C2779244835","wikidata":"https://www.wikidata.org/wiki/Q538432","display_name":"Synovitis","level":3,"score":0.37439998984336853},{"id":"https://openalex.org/C2778720950","wikidata":"https://www.wikidata.org/wiki/Q424972","display_name":"Prednisone","level":2,"score":0.37290000915527344},{"id":"https://openalex.org/C141071460","wikidata":"https://www.wikidata.org/wiki/Q40821","display_name":"Surgery","level":1,"score":0.3621000051498413},{"id":"https://openalex.org/C126322002","wikidata":"https://www.wikidata.org/wiki/Q11180","display_name":"Internal medicine","level":1,"score":0.3515999913215637},{"id":"https://openalex.org/C1862650","wikidata":"https://www.wikidata.org/wiki/Q186005","display_name":"Physical therapy","level":1,"score":0.3450999855995178},{"id":"https://openalex.org/C2780574019","wikidata":"https://www.wikidata.org/wiki/Q861224","display_name":"Juvenile rheumatoid arthritis","level":3,"score":0.3246000111103058},{"id":"https://openalex.org/C2780366729","wikidata":"https://www.wikidata.org/wiki/Q3350500","display_name":"Oligoarthritis","level":4,"score":0.3199999928474426},{"id":"https://openalex.org/C205545832","wikidata":"https://www.wikidata.org/wiki/Q17156455","display_name":"Young adult","level":2,"score":0.29420000314712524},{"id":"https://openalex.org/C2778917330","wikidata":"https://www.wikidata.org/wiki/Q1274464","display_name":"Polyarthritis","level":3,"score":0.28780001401901245},{"id":"https://openalex.org/C2776804153","wikidata":"https://www.wikidata.org/wiki/Q210420","display_name":"Corticosteroid","level":2,"score":0.28519999980926514},{"id":"https://openalex.org/C2776260265","wikidata":"https://www.wikidata.org/wiki/Q511097","display_name":"Psoriatic arthritis","level":3,"score":0.2702000141143799},{"id":"https://openalex.org/C197934379","wikidata":"https://www.wikidata.org/wiki/Q2047938","display_name":"Adverse effect","level":2,"score":0.25279998779296875},{"id":"https://openalex.org/C2778091532","wikidata":"https://www.wikidata.org/wiki/Q420574","display_name":"HLA-B27","level":4,"score":0.2524000108242035}],"mesh":[],"locations_count":2,"locations":[{"id":"doi:10.1093/rap/rkag113.022","doi":"https://doi.org/10.1093/rap/rkag113.022","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.022","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},{"id":"pmh:oai:pubmedcentral.nih.gov:13728712","doi":null,"is_oa":true,"landing_page_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728712/","pdf_url":"https://pmc.ncbi.nlm.nih.gov/articles/PMC13728712/pdf/rkag113.022.pdf","source":{"id":"https://openalex.org/S2764455111","display_name":"PubMed Central","issn_l":null,"issn":null,"is_oa":true,"is_in_doaj":false,"is_core":false,"listed_in":[],"host_organization":"https://openalex.org/I1299303238","host_organization_name":"National Institutes of Health","host_organization_lineage":["https://openalex.org/I1299303238"],"host_organization_lineage_names":[],"type":"repository"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatol Adv Pract","raw_type":"Text"}],"best_oa_location":{"id":"doi:10.1093/rap/rkag113.022","doi":"https://doi.org/10.1093/rap/rkag113.022","is_oa":true,"landing_page_url":"https://doi.org/10.1093/rap/rkag113.022","pdf_url":null,"source":{"id":"https://openalex.org/S2735938563","display_name":"Rheumatology Advances in Practice","issn_l":"2514-1775","issn":["2514-1775"],"is_oa":true,"is_in_doaj":true,"is_core":true,"listed_in":["cwts-core","doaj","jufo-1","ki-jl-1","norway-1","oarl","poland-20","russia-white-list-3","vabb-shw"],"host_organization":"https://openalex.org/P4310311648","host_organization_name":"Oxford University Press","host_organization_lineage":["https://openalex.org/P4310311648","https://openalex.org/P4310311647"],"host_organization_lineage_names":["Oxford University Press","University of Oxford"],"type":"journal"},"license":"cc-by","license_id":"https://openalex.org/licenses/cc-by","version":"publishedVersion","is_accepted":true,"is_published":true,"raw_source_name":"Rheumatology Advances in Practice","raw_type":"journal-article"},"sustainable_development_goals":[{"score":1.0,"id":"https://metadata.un.org/sdg/3","display_name":"Good health and well-being"}],"study_designs":[],"awards":[],"funders":[],"has_content":{"pdf":true,"grobid_xml":true},"content_urls":{"pdf":"https://content.openalex.org/works/W7225201369.pdf","grobid_xml":"https://content.openalex.org/works/W7225201369.grobid-xml"},"referenced_works_count":0,"referenced_works":[],"related_works":["https://openalex.org/W7225169275","https://openalex.org/W2252709839","https://openalex.org/W3095696487","https://openalex.org/W7225171554","https://openalex.org/W2056361702","https://openalex.org/W4399483465","https://openalex.org/W2890641948","https://openalex.org/W2892343312","https://openalex.org/W3042288311","https://openalex.org/W4297797169"],"abstract_inverted_index":{"Abstract":[0],"Introduction":[1],"Juvenile":[2],"idiopathic":[3],"arthritis":[4,195,264,422,651],"(JIA)":[5],"frequently":[6,392],"persists":[7],"into":[8,260,418,627,647],"adulthood,":[9],"yet":[10],"patients":[11,672],"achieving":[12],"prolonged":[13,182,333,481,643],"remission":[14,183,215,401,644],"during":[15,239,524,652],"adolescence":[16],"are":[17],"often":[18],"expected":[19],"to":[20,28,74,150,208,231,298,314,395,435,580,658,678,759],"have":[21,550],"favourable":[22],"long-term":[23,378,761],"outcomes.":[24,762],"Transition":[25,655],"from":[26,656],"paediatric":[27,657,727],"adult":[29,75,232,410,576,659,718,725],"rheumatology":[30,660],"represents":[31],"a":[32,48,235,529,611,662,746,751],"vulnerable":[33,534],"period":[34,527,664],"where":[35],"disease":[36,61,71,137,146,155,301,348,384,407,475,552,588],"relapse,":[37],"treatment":[38,223,464,684],"interruption":[39],"and":[40,88,122,148,163,171,196,253,271,291,306,332,368,398,448,467,515,584,602,645,683,691,710,726],"evolving":[41],"management":[42,125,274,616],"challenges":[43,517],"may":[44,640],"emerge.":[45],"We":[46],"present":[47],"patient":[49,100,415],"with":[50,103,159,213,245,320,360,427,542,624,629,673,755],"extended":[51,105,389],"oligoarticular":[52,106,390,638],"ANA-positive":[53,104],"JIA":[54,107,381,391,609,625,639,719],"diagnosed":[55,102],"aged":[56],"two":[57,109,218],"years":[58,65,110,355],"who":[59],"maintained":[60],"control":[62,385,589],"for":[63,216,539],"many":[64],"before":[66,192],"developing":[67],"severe,":[68],"treatment-refractory":[69],"polyarticular":[70,262],"following":[72,280,528],"transition":[73,221,496,526,741],"services.":[76,233,503],"This":[77,373,736],"case":[78,374,491,567,737],"highlights":[79,568],"the":[80,89,117,145,240,376,436,444,525,569,705],"complexities":[81],"of":[82,92,111,135,194,202,380,438,446,463,560,607,668,693,702,707,716],"transitional":[83],"care,":[84,669],"biologic":[85,311,351,582,689,709],"sequencing,":[86],"immunogenicity":[87],"cumulative":[90],"burden":[91],"chronic":[93,543],"glucocorticoid":[94,429,482,698],"dependence.":[95,430],"Case":[96],"description":[97],"A":[98],"male":[99],"was":[101,184,187,225,441],"at":[108],"age":[112],"after":[113,642],"recurrent":[114,681],"synovitis":[115],"affecting":[116],"left":[118],"knee,":[119],"ankle,":[120],"elbow":[121],"wrist.":[123],"Initial":[124],"included":[126],"repeated":[127,294],"intra-articular":[128,179,326],"corticosteroid":[129,180,327],"injections":[130],"followed":[131],"by":[132],"methotrexate":[133,160,205,295],"because":[134],"persistent":[136,261,428],"activity.":[138],"Bilateral":[139],"anterior":[140],"uveitis":[141,197],"developed":[142,279],"early":[143],"in":[144,190,198,211,323,338,409,485,574,671],"course":[147],"responded":[149],"topical":[151],"corticosteroids.":[152],"Throughout":[153],"childhood,":[154,505],"activity":[156],"gradually":[157],"improved":[158],"alongside":[161,293],"physiotherapy":[162],"supportive":[164],"multidisciplinary":[165,370,507,593,722],"input":[166],"addressing":[167],"hypermobility,":[168],"musculoskeletal":[169,510],"rehabilitation":[170],"school-related":[172],"difficulties.":[173],"Despite":[174,578],"intermittent":[175],"knee":[176,248],"flares":[177],"requiring":[178,423,592,614,665],"injections,":[181,328],"achieved.":[185],"Methotrexate":[186],"successfully":[188],"withdrawn":[189],"2013":[191],"relapse":[193,522,641],"2014":[199],"necessitated":[200],"recommencement":[201],"therapy.":[203],"Ongoing":[204],"intolerance":[206],"led":[207],"adalimumab":[209],"initiation":[210],"2015":[212],"sustained":[214,300,406,756],"over":[217],"years.":[219],"As":[220],"approached,":[222],"de-escalation":[224],"considered":[226],"but":[227,557],"deferred":[228],"until":[229],"transfer":[230,501,753],"Following":[234,412],"missed":[236,530],"adolescent":[237],"follow-up":[238],"COVID-19":[241],"pandemic,":[242],"he":[243,357],"re-presented":[244],"severe":[246,648],"bilateral":[247],"synovitis,":[249],"inflammatory":[250,263,346,362,421,473,650],"marker":[251],"elevation":[252],"marked":[254],"functional":[255],"deterioration.":[256],"Disease":[257,521],"rapidly":[258],"evolved":[259],"involving":[265],"knees,":[266],"ankles,":[267],"hips,":[268],"wrists,":[269],"elbows":[270],"hands.":[272],"Subsequent":[273],"proved":[275],"challenging.":[276],"Anti-adalimumab":[277],"antibodies":[278],"biosimilar":[281],"reintroduction.":[282],"Sequential":[283],"therapies":[284,312,367,426],"including":[285,518],"etanercept,":[286],"infliximab,":[287],"tocilizumab,":[288],"abatacept,":[289],"upadacitinib":[290],"certolizumab,":[292],"courses,":[296],"failed":[297],"achieve":[299],"control.":[302],"Recurrent":[303,455],"respiratory,":[304],"urinary":[305],"ENT":[307],"infections":[308,456,682],"repeatedly":[309,457],"interrupted":[310,458],"leading":[313],"longer":[315],"periods":[316],"trialling":[317],"these":[318],"agents":[319],"steroid":[321,469],"use":[322],"between.":[324],"Numerous":[325],"intravenous":[329],"methylprednisolone":[330],"admissions":[331],"oral":[334],"prednisolone":[335],"dependence":[336],"resulted":[337,484],"cushingoid":[339],"features.":[340],"Additional":[341],"diagnostic":[342],"uncertainty":[343],"surrounding":[344],"possible":[345],"bowel":[347,474],"further":[349,476],"complicated":[350],"selection.":[352],"At":[353],"23":[354],"old":[356],"remains":[358,563,590],"steroid-dependent":[359],"active":[361,631],"polyarthritis":[363],"despite":[364,382,704],"multiple":[365,581,708],"advanced":[366,425],"ongoing":[369,630],"review.":[371],"Discussion":[372],"illustrates":[375],"unpredictable":[377],"trajectory":[379,553],"excellent":[383],"throughout":[386],"childhood.":[387],"Although":[388],"responds":[393],"well":[394],"conventional":[396],"DMARDs":[397],"TNF":[399,679],"inhibition,":[400],"does":[402],"not":[403],"necessarily":[404],"predict":[405],"quiescence":[408],"life.":[411],"transition,":[413],"this":[414,490,535,566],"experienced":[416],"transformation":[417],"aggressive,":[419],"refractory":[420,575,608,649,717],"sequential":[424],"Several":[431],"factors":[432],"likely":[433],"contributed":[434],"complexity":[437],"management.":[439],"Immunogenicity":[440,677],"demonstrated":[442],"through":[443],"development":[445],"anti-adalimumab":[447],"later":[449],"infliximab":[450],"antibodies,":[451],"limiting":[452],"therapeutic":[453,478,572,694],"efficacy.":[454],"treatment,":[459],"making":[460],"adequate":[461],"assessment":[462,692],"response":[465],"difficult":[466],"delaying":[468],"reduction.":[470],"Potential":[471],"co-existent":[472],"restricted":[477],"choices":[479],"while":[480],"exposure":[483,579],"significant":[486],"treatment-related":[487],"morbidity.":[488],"Importantly,":[489],"also":[492],"demonstrates":[493],"that":[494,739],"successful":[495,740],"encompasses":[497],"considerably":[498],"more":[499,622],"than":[500,750],"between":[502,724],"During":[504],"coordinated":[506],"care":[508,562],"addressed":[509],"rehabilitation,":[511],"ophthalmological":[512],"surveillance,":[513],"education":[514],"psychosocial":[516],"school":[519],"bullying.":[520],"occurred":[523],"review,":[531],"emphasising":[532],"how":[533],"stage":[536],"can":[537,686],"be":[538,555,743],"young":[540],"people":[541],"rheumatic":[544],"disease.":[545,632],"Whether":[546],"earlier":[547],"re-engagement":[548],"would":[549],"altered":[551],"cannot":[554],"determined,":[556],"maintaining":[558],"continuity":[559,667],"specialist":[561,732],"essential.":[564],"Finally,":[565],"increasingly":[570,619],"complex":[571],"landscape":[573],"JIA.":[577],"classes":[583],"targeted":[585,711],"synthetic":[586,712],"DMARDs,":[587],"elusive,":[591],"discussion":[594],"regarding":[595],"unconventional":[596],"combination":[597],"therapy,":[598],"alternative":[599],"cytokine":[600],"targets":[601],"clinical":[603],"trial":[604],"enrolment.":[605],"Recognition":[606],"as":[610,621,745],"distinct":[612],"phenotype":[613],"individualised":[615],"is":[617,661],"becoming":[618],"important":[620],"children":[623],"survive":[626],"adulthood":[628],"Key":[633],"learning":[634],"points":[635],"\u2022":[636,654,676,696,714,735],"Extended":[637],"evolve":[646],"adulthood.":[653],"high-risk":[663],"robust":[666],"even":[670],"longstanding":[674],"remission.":[675],"inhibitors,":[680],"interruptions":[685],"significantly":[687],"complicate":[688],"sequencing":[690],"response.":[695],"Long-term":[697],"dependenceremainsa":[699],"major":[700],"source":[701],"morbidity":[703],"availability":[706],"therapies.":[713],"Management":[715],"requires":[720],"close":[721],"collaboration":[723],"rheumatology,":[728],"ophthalmology,":[729],"gastroenterology,":[730],"physiotherapy,psychologyand":[731],"nursing":[733],"teams.":[734],"reinforces":[738],"should":[742],"viewed":[744],"longitudinal":[747],"process":[748],"rather":[749],"single":[752],"event,":[754],"engagement":[757],"andmonitoringessential":[758],"optimise":[760]},"counts_by_year":[],"updated_date":"2026-11-07T11:25:07.637180","created_date":"2026-11-04T00:00:00"}