tumor necrosis factor (TNF) inhibitor — Blue Cross Blue Shield of Kansas

Initial criteria

• Diagnosis of ERA with onset before age 16 years
• Failure or intolerance to treatment with at least 2 non-steroidal anti-inflammatory drugs (NSAIDs) after ≥4 total weeks of therapy
• TNF-inhibitor is conditionally recommended over methotrexate or sulfasalazine if disease remains active despite NSAIDs
• Bridging therapy with oral glucocorticoids ≤3 months may be used during therapy initiation or escalation