This research project is in progress. PCORI will post the research findings on this page within 90 days after the results are final.
What is the research about?
About 300,000 children in the United States have juvenile idiopathic arthritis (JIA). JIA causes joint stiffness, swelling, and damage. It can also cause problems with bone development and growth. More than half of children with JIA have a form of the disease called polyarticular JIA (pJIA), which causes swelling in five or more joints. Having pJIA can make it hard to do daily activities such as getting dressed, brushing teeth, eating, and climbing stairs. Because of painful bone and joint problems, children with pJIA may be less involved than their peers in school and social activities.
There is no cure for pJIA, but treatments are available. One type of treatment is called biologic disease-modifying medicines. These medicines are based on substances found in living things and can help limit inflammation in the joints. Another type of treatment, nonbiologic disease-modifying medicines, slows down pJIA and can also help limit inflammation in the joints. Biologic medicines show promise in treating pJIA, but doctors don’t know much about their side effects. Doctors also don’t know how biologic medicines compare with nonbiologic medicines, or which type of medicine to give first if their patients are considering taking both. Patients usually start with a nonbiologic medicine. If it doesn’t work, then they move on to a biologic medicine. Doctors and researchers want to know whether starting a biologic medicine earlier or by itself would lessen bone or joint damage, or whether it would cause more side effects, or both.
Who can this research help?
Results from this research can help doctors, patients, and families decide which treatment to try first to improve the lives of children with pJIA.
What is the research team doing?
The research team is recruiting 400 children aged 2–18 with pJIA and their parents for this study. Doctors involved in the study talk to patients during appointments about the treatment options and their advantages and disadvantages. Patients and their families work with their doctors to choose a treatment plan among three options:
- Patients start treatment with a nonbiologic disease-modifying drug. They may also take a biologic medicine later, if their doctor thinks it’s necessary.
- Patients start treatment with both the nonbiologic and the biologic medicine
- Patients take the biologic medicine only.
During clinic visits over 12 months, researchers are collecting information about patients’ pain and their ability to move. Researchers also are collecting information about how much swelling and inflammation is happening in patients’ joints.
The research team is working with patients, families, and others who are interested in pJIA to better understand how pJIA affects patients and their families, and how to measure these effects.