Strategies towards personalised treatment in Juvenile Idiopathic Arthritis (JIA)

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About the project

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 JIA, but the majority of patients do not achieve a disease activity-free state. Cortisone injections into inflamed joints are widely used, but the procedure is painful and usually requires general anesthesia in children. No controlled studies have measured the effect of joint injections, and we do not know whether joint injections provide additional benefit in JIA patients starting treatment with TNF inhibitors.

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

The main 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 provide an additional effect when starting TNF inhibitors in pediatric arthritis? Both possible outcomes of the study will have implications for clinical practice. If a strategy that includes joint injections is best, the MinJIA study will contribute to evidence-based recommendations with more emphasis on joint injections. If it turns out that cortisone injections in all inflamed joints are unnecessary when starting TNF inhibitor treatment, clinical practice will change so that children, adolescents and families can be spared unpleasant and time-consuming procedures and costs to society can be reduced.

Who can participate?

MinJIA is a multicenter study with the following centers: Oslo University Hospital is the coordinating center for the study. In addition, the pediatric departments at Stavanger University Hospital, Haukeland University Hospital, St. Olavs Hospital and the University Hospital of North Norway are study centers.

The study includes children and adolescents 1 - 18 years of age who have active juvenile idiopathic arthritis and who are being considered to start a tumor necrosis factor (TNF) inhibitor. Patients at the centers that are actively participating in the study can be included if they meet the eligibility criteria. This is assessed by study staff at the center.

Recruitment in the study is ongoing.

Project arrangement

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

Clinical examinations, ultrasound and, if necessary, MRI of joints are performed. Parents and patients fill in questionnaires on self-perceived health. Blood samples to measure drug concentration and immunogenetic tests are collected. By analyzing multiple factors, the study will contribute to the development of personalized treatment for childhood arthritis.


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