Synopsis
Deliver planned, developmentally appropriate transition for young people with juvenile idiopathic arthritis, preserving disease control, uveitis surveillance, medicine safety, self-management and continuity across paediatric and adult services.
- Transition is a planned process that begins early in adolescence; transfer is the single administrative event within it.
- Identify a named coordinator and adult service, involve the young person directly and adapt timing to developmental readiness rather than eighteenth birthday alone.
- Transfer a complete disease summary: JIA category, joint and extra-articular history, damage, uveitis, surgeries, medicines, failures, adverse reactions, monitoring, vaccines and current goals.
Key red flags
Systemic-JIA fever with falling platelets, fibrinogen, liver dysfunction, coagulopathy or neurological change requires urgent multidisciplinary care.
Investigation priorities
Identify knowledge, self-management, communication and practical gaps before transfer.
Management branches
A young person with JIA is approaching adolescence or adult-service transfer.
- Introduce transition early, identify a coordinator and assess disease knowledge, self-management, communication, education, mental health and family support.
- Provide repeated age-appropriate teaching on medicines, monitoring, uveitis, infection, reproductive health, prescriptions and emergency contacts with private consultation time.
Key medicines
Methotrexate with folic acidContinue the verified specialist dose once weekly, commonly 7.5–25 mg in adult practice. Record one fixed dosing day and prescribe folic acid at least 5 mg once weekly on a different day.
AdalimumabContinue the verified age-, weight- and indication-appropriate specialist regimen; adult maintenance is commonly 40 mg subcutaneously every other week.