Sind die Leitlinien das non plus ultra? Anwendung von Leitlinien bei der JIA im klinischen Alltag

Zusammenfassung

Therapieleitlinien wie sie für die Behandlung der juvenilen idiopathischen Arthritis existieren, sind erforderlich, um den Behandlern, evidenzbasierte therapeutische Strategien in lesbarer, verständlicher und einsetzbarer Form, verfügbar zu machen. In der vorliegenden Übersicht werden wichtige Aspekte der deutschen (GKJR:Gesellschaft für Kinder- und Jugendrheumatologie) und der US-amerikanischen JIA-Leitlinien diskutiert und eine Beurteilung der Qualität von Leitlinien dargestellt. Die US- und die Leitlinie der GKJR sollten aktualisiert werden, um neue Daten, z. B. im Bereich der Biologika-Therapie zu berücksichtigen. Leitlinien der Stufe S2/S3 erfordern einen sehr hohen personellen und finanziellen Aufwand, sind aber ein gutes Instrument, um Behandlern wissenschaftlich geprüfte, von Experten konsentierte und somit praktisch einsetzbare Pfade für die Behandlung von Kindern und Jugendlichen mit JIA aufzuweisen.

Abstract

Therapy guidelines like those existing for the treatment of juvenile idiopathic arthritis are necessary to provide the physician with evidence-based therapeutic options in an easily readable, understandable and applicable form. In the present review important aspects of the German and US-American guidelines for JIA are discussed and an assessment of the quality of the guidelines is presented. The American and GKJR guidelines need to be updated, to include new data, e. g., in the field of therapy with biologicals. Guidelines of the S2/S3 demand a high level investment of personal effort and costs, but are a good instrument to provide physicians with paths for scientifically proven procedures formulated under expert consensus and practical day to day approaches for the treatment of children and adolescents with JIA.

Schlüsselwörter

Juvenile idiopathische Arthritis - Leitlinien - Konsensus-bildung

Key words

juvenile idiopathic arthritis - therapy guidelines - consensus process

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