Systemic Juvenile Idiopathic Arthritis: The Challenges and Opportunities

Systemic juvenile idiopathic arthritis (SJIA), presently included under the broad taxonomy of Still's disease along with 'Adult-onset Stills disease', is a unique disease entity, characterised predominantly by features of systemic inflammation at disease onset and running a heterogenous course, evolving into a disabling chronic, destructive arthritis in a sizable proportion of patients. With a better understanding of the disease biology, there has been a paradigm shift in therapeutic strategy targeting immunological remission. With the evolution of better biomarkers (to guide diagnosis, predict complications and predict treatment responses) and robust therapeutic options and treatment targets, newer challenges such as refractory disease states and SJIA-associated lung disease have risen to the fore, making disease management all the more challenging.