{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,2]],"date-time":"2026-10-02T00:54:07Z","timestamp":1790902447731,"version":"4.1.0"},"reference-count":25,"publisher":"Springer Science and Business Media LLC","issue":"1","license":[{"start":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T00:00:00Z","timestamp":1790121600000},"content-version":"tdm","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"},{"start":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T00:00:00Z","timestamp":1790812800000},"content-version":"vor","delay-in-days":8,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0"}],"funder":[{"DOI":"10.13039\/501100000024","name":"Canadian Institutes of Health Research","doi-asserted-by":"publisher","award":["318280"],"award-info":[{"award-number":["318280"]}],"id":[{"id":"10.13039\/501100000024","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100008762","name":"Genome Canada","doi-asserted-by":"publisher","award":["OGI-150"],"award-info":[{"award-number":["OGI-150"]}],"id":[{"id":"10.13039\/100008762","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/100013061","name":"Ontario Genomics","doi-asserted-by":"publisher","id":[{"id":"10.13039\/100013061","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100000142","name":"Arthritis Society","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100000142","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100001826","name":"ZonMw","doi-asserted-by":"publisher","award":["848006001"],"award-info":[{"award-number":["848006001"]}],"id":[{"id":"10.13039\/501100001826","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100006315","name":"ReumaNederland","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100006315","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100003206","name":"Alberta Children's Hospital Foundation","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100003206","id-type":"DOI","asserted-by":"publisher"}]},{"DOI":"10.13039\/501100010787","name":"Genome Alberta","doi-asserted-by":"publisher","id":[{"id":"10.13039\/501100010787","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["link.springer.com"],"crossmark-restriction":false},"short-container-title":["Pediatr Rheumatol"],"abstract":"<jats:title>Abstract<\/jats:title>\n                  <jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess adherence to Treat-to-Target (T2T) recommendations for juvenile idiopathic arthritis (JIA) in clinical practice.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>A nested cohort study in the multicenter international prospective UCAN JIA cohort was performed. Patient characteristics, clinical features, classification, disease activity as measured by number of active joints (AJC), Physician Global Assessment (PhGA) and Patient Global Assessment (PPGA) and treatment at baseline and six-months visit was assessed. Data were compared to published, consensus-based T2T recommendations. Logistic regression with step-wise selected variables identified factors related to the decision to change therapy.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>A total of 476 children were included, 62% female, median age was 10.0 years. At baseline, anti-inflammatory medications (NSAID) and\/or intra-articular injections were started in 53%, conventional synthetic anti-rheumatic drugs (csDMARD) in 37% and biologic therapies in 11%. At six-months, 248 patients (52%) had inactive arthritis based on AJC. PPGA was not collected for 35% of patients. In children with arthritis, treatment change as suggested in the recommendations were only made in 33%. Patients that had no treatment change were more often already treated with a csDMARD or biological or had limited number of joints affected. Multivariate logistic regression showed that the decision to change treatment at six-months was significantly related to PhGA, prior treatment changes and use of csDMARD or biological since baseline.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>PPGA is not consistently collected, hampering measurement-based care and T2T. PhGA and prior treatment steps are underlying current treatment decisions, but often not according to the T2T cut-offs and time-points that have been agreed upon in consensus.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1186\/s12969-026-01265-w","type":"journal-article","created":{"date-parts":[[2026,9,23]],"date-time":"2026-09-23T08:16:18Z","timestamp":1790151378000},"update-policy":"https:\/\/doi.org\/10.1007\/springer_crossmark_policy","source":"Crossref","is-referenced-by-count":0,"title":["Adherence to treat-to-target recommendations in juvenile idiopathic arthritis in clinical practice"],"prefix":"10.1186","volume":"24","author":[{"ORCID":"https:\/\/orcid.org\/0009-0003-7281-1304","authenticated-orcid":false,"given":"S.","family":"De Roock","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1610-8721","authenticated-orcid":false,"given":"P. C. 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Reference ethical approvals were granted by the University of Calgary (Conjoint Health Research Ethics Board, REB17\u20131563) for Canada and by the Ethical Board of Utrecht (18\u2013474) for the Netherlands.","order":1,"name":"Ethics","label":"Ethics approval and consent to participate","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"All authors consent to publication.","order":2,"name":"Ethics","label":"Consent for publication","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"The international multi-center UCAN CAN-DU study prospectively enrolls children with arthritis across Canada and the Netherlands. Patients and parents were involved in the writing of the UCAN CAN-DU grant and are involved in the research project.","order":3,"name":"Ethics","label":"Patient and public involvement","group":{"name":"EthicsHeading","label":"Declarations"}},{"value":"S. J. Vastert reports consulting, funding grants, and speaking fees from Sobi; consulting and speaking fees from Novartis. R. S. M. Yeung reports consulting fees from Sobi. J. F. Swart reports consulting fees, funding grants, and lecture fees from Pfizer; advisory fees from Bristol-Myers Squibb. S. M. Benseler declares lecture fees from Novartis. All other authors declare that they have no competing interests.","order":4,"name":"Ethics","label":"Competing interests","group":{"name":"EthicsHeading","label":"Declarations"}}],"article-number":"67"}}