Outcomes in JIA have greatly improved, but we can still do better

Abstract Outcomes for children and adolescents with juvenile idiopathic arthritis (JIA) have improved substantially over the past two decades, driven by biologic and targeted synthetic DMARDs, treat-to-target strategies with regular standardized assessments, and multidisciplinary specialist care. These advances have reduced mortality to near-population levels, increased remission rates, and minimized long-term joint damage. Yet progress remains uneven across JIA categories, and many young people still experience persistent pain, fatigue, psychosocial burden, and reduced quality of life despite adequate inflammatory control. Early diagnosis and timely initiation of effective therapy remain critical but remain inconsistent. The lack of reliable biomarkers or predictors of treatment response continues to limit individualized care, reinforcing trial-and-error prescribing. Future priorities include precision medicine approaches, consistent outcome measurement, stronger multidisciplinary models, and structured transition to adult services. Active patient involvement in research and care is essential to ensure equitable, patient-centred progress.