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Strategies for personalized treatment of juvenile idiopathic arthritis (JIA)

Post doc


Juvenile idiopathic arthritis (JIA) is a chronic disease with inflammation of the joints that can lead to damage and loss of function. New drugs and treatment strategies, such as tumor necrosis factor (TNF) inhibitors, have improved the course of the disease in JIA, but the majority of patients do not achieve a state without disease activity. Cortisone injections into inflamed joints are widely used, but the procedure is painful and usually requires anesthesia in children. No controlled studies have measured the effect of joint injections, and we do not know whether joint injections have an additional effect in JIA patients who start treatment with TNF inhibitors.

MinJIA is a national randomized study where the aim is to investigate whether joint injections in combination with a TNF inhibitor are more effective than TNF inhibitors alone. All health regions participate, and the study is led from Oslo University Hospital.

The most important outcome measure is remission, which means no symptoms or signs of active disease.

The research question behind the study is: Do cortisone injections in inflamed joints have an additional effect when a TNF inhibitor is started in childhood arthritis? Both possible outcomes of the study will have significance for clinical practice. If a strategy that includes joint injections is best, the MinJIA study will contribute to knowledge-based recommendations with more emphasis on joint injections. If it turns out that cortisone injections in all inflamed joints are redundant when TNF inhibitor treatment is started, clinical practice will change so that children, young people and families can be spared unpleasant and time-consuming procedures, and costs for society can be reduced.



MinJIA is a multi-centre study with the following centres: Oslo University Hospital is the coordinating center for the study. In addition, the children's wards at Stavanger University Hospital, Haukeland University Hospital, St.Olavs Hospital and the University Hospital in Northern Norway are study centres.

The study includes children and young people aged 1-18 who have active childhood arthritis (juvenile idiopathic arthritis) and where it is considered to start with a tumor necrosis factor (TNF) inhibitor. Patients at the centers that are active in the study can participate if they meet the criteria for participation. This is assessed by study staff at the centre.

Recruitment in the study is ongoing.


202 children are included and followed with modern treatment principles for one year.

Clinical examinations, ultrasound and, if necessary, MRI of joints are carried out. Parents and patients fill in questionnaires about self-perceived health. Blood samples for measuring drug concentration and immunogenetic tests are collected. Through analysis of various factors, the study will contribute to the development of personalized treatment for childhood arthritis.