Navigating Pediatric Arthritis Care and the Challenges of Transition, With Yukiko Kimura, MD

Juvenile idiopathic arthritis (JIA) and other pediatric rheumatic diseases pose unique challenges not only because of their impact on growing bones and joints but also due to the complexities of long-term management. Pediatric rheumatology is about far more than symptom control—it requires early intervention, careful use of advanced therapies, and seamless coordination across specialties to optimize outcomes. Timely referral to pediatric rheumatologists is especially critical, as recent research has shown that initiating biologic treatment within 2 months of diagnosis can significantly improve long-term disease activity compared with delayed intervention.1

A major hurdle in this field remains the transition from pediatric to adult care. For many young patients, moving from a family-centered pediatric model to the more independent adult system is abrupt and overwhelming. Adolescents often struggle with suddenly managing their own complex regimens, and gaps in support can lead to lapses in care. Adding to this challenge, childhood arthritis is not always identical to its adult counterparts. Manifestations like temporomandibular joint (TMJ) arthritis and unique forms of eye inflammation are far more common in children, underscoring the need for specialized expertise that adult providers may not be familiar with.

Collaboration between pediatric rheumatologists and primary care pediatricians plays a central role in bridging these gaps. Pediatricians remain critical for overseeing broader aspects of child health, while rheumatologists focus on disease-specific management.

HCPLive spoke with Julie Kimura, MD, Chief of Pediatric Rheumatology at Hackensack University Medical Center, and Professor of Pediatrics at the Hackensack Meridian School of Medicine, to learn more about transitioning care between childhood and adulthood.

For adult rheumatologists, Kimura stresses the importance of both recognizing the safety and efficacy of biologics in younger patients and not hesitating to consult pediatric specialists when needed. These partnerships, combined with ongoing research efforts like the Stop JIA study, reflect a growing focus on refining when and how to use modern therapies to ensure children with arthritis achieve the best possible outcomes.2

References

1. Shishov M, Weiss PF, Levy DM, et al. 25 Years of Biologics for the Treatment of Pediatric Rheumatic Disease: Advances in Prognosis and Ongoing Challenges. Arthritis Care Res (Hoboken). 2025;77(5):573-583. doi:10.1002/acr.25482

2. Trial of Sequential Medications After TNF Failure (SMART) and Precision Treatment Decisions in Juvenile Idiopathic Arthritis. CARRA. https://carragroup.org/grant/trial-of-sequential-medications-after-tnf-failure-smart-and-precision-treatment-decisions-in-juvenile-idiopathic-arthritis/