Landmark Polyarticular JIA Study Reports First Findings

Landmark Polyarticular JIA Study
Reports First Findings

Two papers presenting results from the Start Time Optimization of Biologics in Polyarticular Juvenile Idiopathic Arthritis (STOP-JIA) Study were recently published in Arthritis and Rheumatology. CARRA researchers began this study in 2015, and it was the first study to determine which consensus treatment plan (CTP) developed for children with newly diagnosed polyarticular JIA (pJIA; arthritis involving >= 5 joints during the first 6 months) would result in the best outcomes. The CTPs studied were:

  • Step Up: starting treatment with a disease-modifying antirheumatic drug (DMARD) which is not a biologic. An example is methotrexate. A biologic would be added 3 or more months later, if the DMARD was not working well enough.
  • Early Combination: starting treatment with both a DMARD and a biologic. Examples of biologics include etanercept (Enbrel®), adalimumab (Humira®), abatacept (Orencia®), and tocilizumab (Actemra®).
  • Biologic First: starting treatment with a biologic only, adding a DMARD later if needed.

The main results of the study showed that of 400 patients enrolled in 56 CARRA Registry sites around the U.S. and Canada, most patients began Step Up treatment, followed by Early Combination, then Biologics First. Across all three CTPs, there was not a major difference in patients reaching the study’s main goal of inactive disease off steroid medications at one year, but all patients had improved pain and mobility on all three plans. However, it appeared that other secondary disease activity outcomes were better in the patients started on the Early Combination CTP compared to the Step Up CTP.

Further research supported these results and were published in the second article. It showed that early use of biologic treatment within three months of pJIA diagnosis led to faster improvement in disease activity for some patients. Because the CARRA Registry follows all participants for at least ten years, researchers will be able to see how these initial treatments impact longer term outcomes. The STOP-JIA study will continue to uncover important information to help patients, families and clinicians make informed decisions about treating pJIA.

Congratulations to Yuki Kimura and Mei-Sing Ong, the STOP-JIA study team and all CARRA members and sites who participated in the study!