CARRA Newsletter
February 9, 2016
Table of Contents
We are adding a new feature to our weekly newsletter, organized by Brian Feldman and Jay Mehta...
The Microbiome and JIA by Brian Feldman
In case you missed it, the microbiome is really hot news these days.
There are those who think the microbiome is the answer to everything 1, or at least really important 2; but, there are others who think, well... not so much 3

(For a balanced look, check out Hanage WP. Microbiology: Microbiome science needs a healthy dose of skepticism. Nature 2014;512:247-8 .)

So it was with some interest that we read Daniel Horton's paper in Pediatrics4. In it he, and his team at U Penn, Rutgers, and the Alfred I. duPont Hospital for Children, suggest that "Antibiotic exposure may play a role in JIA pathogenesis, perhaps mediated through alterations in the microbiome."

The team was interested in earlier reports that antibiotic use seems to lead to JIA5. They were-rightly, we think-worried that people get antibiotics for infections, and maybe it was the infections, rather that the antibiotics, that led to children developing arthritis, or even, maybe, that children were being treated with antibiotics because they had early symptoms of JIA.

Horton and the team were determined to figure this out by doing a study that wouldn't mix these things up. They had access to the UK health improvement network, which is a really big EMR database from over 500 UK general practices. The children they looked at were followed, essentially, from birth. They were able to pick out the children that developed arthritis, and when. They were also able to see when the children were given (or at least prescribed) antibiotics in the years just before developing arthritis. They matched each arthritis child with 10 who didn't develop arthritis to compare antibiotic use. Then they used some fancy epidemiologic mojo to try and get rid of the problems of the earlier study.
What they found was that children who developed arthritis had twice the odds of having had a prescription for antibiotics than children who didn't develop arthritis. Horton and his team made some pretty convincing arguments about why - i) infections being the cause of the arthritis, and ii) antibiotics being used to treat early symptoms of arthritis - weren't enough (likely) to explain away all of this relationship.

Is it the microbiome? Is there something else that explains this relationship? Well, antibiotics certainly do change around the bacteria (at least, that we are good at measuring) from our gut (at least, those portions that we can measure from). This will likely take some time to sort out, but certainly Dan Horton's paper gives us some food for thought.
MtgAnn2016 CARRA Scientific Meeting Announcements
We are planning an exciting meeting this spring and are looking forward to seeing everybody again!  This year the CARRA Annual Scientific Meeting will be held April 14-17 in Toronto with preconference meetings scheduled for April 13/14.  Read more here .

Meeting registration is now OPEN! Click here for more  details.

Registry and STOP-JIA Investigators' and Coordinators' Meeting Plan to arrive in Toronto on April 13th to attend this important meeting on April 14, 10 AM-2 PM. CARRA will provide additional travel support (funding to cover ½ single or double room to stay at the hotel Wednesday 4/13) to the PI (or alternate investigator) and one coordinator per Registry site. All investigators are encouraged to attend. Coordinators will attend additional meetings at 7:30 AM and 2:30 PM on April 14th. See pre-conference section of the agenda for  additional information. 

Deadline for Pediatric Residents Program extended to February 19th. We have a few openings left for our Pediatric Resident Scholarship Program. Please encourage pediatric residents at your site to apply.  Click here for more information.

Abstract deadline extended to February 28th! Guidelines and instructions for submission of abstracts for the CARRA Annual Meeting are here.
regnewsCARRA Registry News

465 patients and counting!  Thank you to coordinators Luke Reichley and Ching Hung (Seattle Children's), Justine Zasa and MaryEllen Riordan (Hackensack), and Gina Dovie, Amy Hanson, and Leif Olson (University of MN) at our top three enrolling sites! Read more

Mark your calendar for the next Coordinator conference call, 02/11, 12 PM EST!  

Webinars for CARRA Members This Week to Review Proposed Charter Changes
Laura Schanberg is hosting two webinars this week for CARRA membership. The purpose of these webinars is to review and discuss changes to the CARRA Charter that were recently approved by the CARRA Steering Committee and will soon be put to a vote by the CARRA Voting Membership.  These changes affect the Executive and Steering Committees. 

Calls are for CARRA members, only, and will be held Thursday February 11th from 3-3:30 PM EST and Friday February 12th from 12:30-1:00 PM EST. To review the changes prior to the webinar, click on either link below, and download the attached file "2016-02-08 PROPOSED CHARTER CHANGES.pdf". 

Click here to join webex Thursday February 11th from 3-3:30 PM EST
US TOLL: +1-415-655-0001; Meeting Number: 198 938 488

Click here to join webex Friday February 12th from 12:30-1:00 PM EST
US TOLL: +1-415-655-0001; Meeting Number: 196 214 315
Important study announcement!   Participate in a study to better understand the clinical characteristics and other factors in sJIA patients whose course has been complicated by pulmonary disease.  Click here for information or contact Michal Cidon, [email protected]

STOP-JIA patient/parent stakeholders have developed a terrific PREZI (presentation software that uses motion, zoom, and spatial relationships) and a newsletter to better inform patients and families.  Click here to see the materials.

Join the discussion on autoinflammatory diseases  at this  blog hosted by CARRA member Jon Hausman!
AFArthritis Foundation Funding Opportunity and Other Announcements

The Arthritis Foundation is now accepting proposals for 2016 scientific discovery awards. Interested investigators should submit a Letter of Intent (LOI) by Feb. 22. More information can be found at

Follow KidsGetArthritisToo on [email protected].
Patients can connect with others at Kids Get Arthritis Too on Facebook .

Registration for the 2016 Juvenile Arthritis Conference is now open! For 4 days every year, the JA Conference becomes a home where families and children share, learn, and bond. Scholarships are available.  Click here for more information and to register.   
ResearchResearch Funding Opportunities

Novartis supports investigator-initiated trials (IIT), both clinical and non-clinical studies.  Guidelines for submitting a proposal for an IIT can be found here .

Bristol-Myers Squibb considers requests for non-interventional research and gives priority to proposals that support their medical plans. Find out how to apply here .

AbbVie's investigator-initiated studies program is accepting applications until March 15 for an April review.  Applications received between March 15-June 15, will be reviewed in July.  Review the process here
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