MinJIA
Strategies for personalized treatment of juvenile idiopathic arthritis (JIA)
Senior researcher
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 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 most often requires 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 who start treatment with TNF inhibitors.
MinJIA is a national randomized study where the aim is to investigate whether joint injections in combination with TNF inhibitor are more effective than TNF inhibitor alone. All health regions are participating, and the study is led by 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 provide an additional effect when starting TNF inhibitor therapy 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 therapy, 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 JOIN?
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. Olav's Hospital and the University Hospital of Northern Norway are study centers.
The study includes children and adolescents 1-18 years of age who have active juvenile idiopathic arthritis and are considering starting 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 personnel at the center.
Recruitment into the study has ended.
WHAT DOES THE STUDY INVOLVE?
202 children are included and followed with modern treatment principles for one year.
Clinical examinations, ultrasound and, if necessary, MRI of the joints are performed. Parents and patients fill out a questionnaire about self-perceived health. Blood samples for measuring drug concentration and immunogenetic tests are collected. Through analysis of multiple factors, the study will contribute to the development of personalized treatment for pediatric arthritis.