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British Society for Rheumatology paediatric and adolescent guidance notes are designed to support those working in paediatric and adolescent care.

Guidance notes are developed to support professionals in several ways, including encouraging a consistent approach to care delivery, promoting the effective use of resources and reducing the likelihood of inappropriate care. Overall, the most important potential benefit is the improvement of the quality of care received by the patient and better health outcomes.

Treatment approaches can vary between clinicians and these guidance notes provide an opportunity to set out best practice based on current evidence or expert consensus. They help to increase consistency in practice and promote the highest standards of care.

Recommendations provided are intended to improve the quality of clinical decision-making, but each individual circumstance may be different and this should be taken into consideration. These notes are subject to revision; we welcome your feedback on any of the documents below.

Please note: many of these documents were produced in collaboration with other organisations, details of which can be found within each specific guidance note.

Methotrexate guidance

Methotrexate guidance for paediatric and adolescent rheumatology health professionals

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Tocilizumab guidance

Tocilizumab guidance for paediatric and adolescent rheumatology health professionals

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Core competencies for AHPs

Competencies for therapists (OTs and physiotherapists) involved in the care of children and young people with rheumatology conditions

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Adalimumab guidance

Adalimumab guidance for paediatric and adolescent rheumatology health professionals 

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Management of symptomatic hypermobility in children and young people

Further information for health professionals involved in the management of children and young people with symptomatic hypermobility

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Core competencies for Clinical Nurse Specialists and Advanced Nurse Practitioners

Administering disease modifying anti-rheumatic drugs (DMARDs) and biologic therapies to children and young people with rheumatological conditions

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Prescribing for children and young people

Standards and responsibilities for shared care protocol for immuno-modulating drugs

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Screening for uveitis in JIA

Guidance for screening to reduce the incidence of visual impairment in children and young people with JIA

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Standards of care for JIA

A statement of minimum standards of care required by children and young people with JIA

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Adolescent transition care

Two-part guidance for seamless transfer

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Administering subcutaneous methotrexate for inflammatory arthritis

Evidence-based guidance for the safe and confident administration of subcutaneous methotrexate in a variety of primary and secondary care settings

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Transitional care

This is the first international set of recommendations and standards for transitional care of young people with juvenile-onset rheumatic diseases and aims to facilitate high-quality models of care for new and existing services.
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Evidence-based recommendations to optimise and disseminate management regimens for children and young adults with rheumatic diseases such as childhood-onset systemic lupus erythematosus (cSLE). Recommendations for cSLE include 11 on diagnosis, nine on disease monitoring and five on general treatment.
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Evidence-based recommendations for the diagnosis and treatment of patients with juvenile dermatomyositis. In total, the document sets out seven overarching principles, 33 recommendations on diagnosis and 19 on therapy.
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Autoinflammatory diseases

Evidence-based recommendations for the management of the autoinflammatory diseases cryopyrin associated periodic syndromes (CAPS), tumour necrosis factor (TNF) receptor associated periodic syndrome (TRAPS) and mevalonate kinase deficiency (MKD).
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Antiphospholipid syndrome

14 evidence-based recommendations for the diagnosis and treatment of paediatric antiphospholipid syndrome (APS).
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