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rheumatology paediatrics

JADAS-27 — Juvenile Arthritis Disease Activity Score

Composite disease-activity score for juvenile idiopathic arthritis (Consolaro 2009). 27-joint count; sum of physician global VAS (0–10) + parent/patient global VAS (0–10) + active joint count (capped 0–10) + ESR (mm/h, transformed: (ESR−20)/10, capped 0–10). Range 0–40.

Score interpretation

Inactive disease / clinical remission 0–1

→ Continue current therapy. Consider taper after sustained remission ≥6 months (per BSPAR / Wallace criteria).

Low disease activity 2–4

→ Optimise current DMARD; treat-to-target. Reassess in 1–3 months.

Moderate disease activity 5–8

→ Step up therapy: methotrexate dose review, add or switch biologic (etanercept, adalimumab, tocilizumab) per NICE TAs.

High disease activity 9–40

→ Urgent paediatric rheumatology review. Consider IV pulse methylprednisolone, switch biologic class, intra-articular steroids, and imaging for joint damage.

Interpretation bands for the JADAS-27. Apply clinical judgement and local guidance.

References

Related

Curated clinical cross-links plus same-class fallbacks.

Decision support only — verify against a current formulary, NICE, or your local guideline before clinical use.