Research & Registry


STOP-JIA (Start Time Optimization of Biologic Therapy in Polyarticular JIA) Study

Why This Is Important

There are a number of effective biologic therapies approved for the treatment of pJIA, but we don’t know if using these treatments first line makes an important difference in how quickly the patients get better, how they do in the long-term, or is safer than starting a traditional non-biologic medicine such as methotrexate first, and only starting a biologic therapy if the traditional medicine doesn’t work.

This is the largest study to compare initial versus delayed biologic therapy in pJIA and is the first large-scale comparative effectiveness study of the CARRA pJIA consensus treatment plans (CTPs).

Patient receiving an IV treatment.

Project Description/Overview

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. The mostly commonly used medications are called nonbiologic disease-modifying medicines. These medications can slow down pJIA progression and can also help limit inflammation in the joints. Another class of medications is called biologic disease-modifying medicines. These medicines are based on substances found in living things and can also help limit inflammation in the joints. Doctors 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. STOP-JIA will help doctors and families understand 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.
Our patient partners are primary members of our study team, and help us improve how the study is conducted by providing both the patient and patient perspectives. We are using electronic questionnaires to assist patients in reporting their symptoms and, for younger children, to enable parents to report their child’s symptoms.


53 CARRA Registry sites are participating across the US and Canada.
The coordinating center is the Duke Clinical Research Institute (DCRI).

JIA Categories
JIA Participating Site Locations

Who is Involved?

Principal Investigator: Yukiko Kimura, MD (Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center)
Co-Principal Investigator: Sarah Ringold, MD MS (Seattle Children’s)


  • Laura Schanberg, MD (Duke Clinical Research Institute and Duke University)
  • Pamela Weiss, MD MSCE (Children’s Hospital of Philadelphia)

Stakeholder Advisory Committee Leaders:

  • Vincent del Gaizo
  • Kate Murphy

Stakeholder Advisory Committee Members:

  • Janet Hobble
  • Uday Deshmukh
  • Nick (Yongjay) Kim
  • Jen Horonjeff
  • Kate Kuhns
  • Charla Cary
  • Suz Schrandt
  • Melanie Kohlheim
  • Lauren Revis


  • Brian Feldman, MD, M.Sc., FRCPC (Toronto Hospital for Sick Children)
  • Marc Natter, MD (Harvard Medical School)

Project Coordinator: Mary Ellen Riordan, BSN, CCRN (Joseph M. Sanzari Children’s Hospital, Hackensack University Medical Center)

Lead Statistician: George Tomlinson, PhD, MSc (University of Toronto)

Coordinating Center: Duke Clinical Research Institute (DCRI)

Additional Information

STOP-JIA is made possible through support from the Patient Centered Outcomes Research Institute (PCORI), and CARRA Registry supporters including the Arthritis Foundation. Blood sample collection is made possible by the Arthritis Foundation to support a study called Precision Decisions (link to PD page).

Links to further details, documents, etc.


The STOP-JIA Prezi was created by JIA patients and parents to help people understand what STOP-JIA is all about. Please take a look and let us know what you think by leaving comments at the bottom of this page.

You may also view the Prezi as a YouTube video here.

The STOP-JIA Times Newsletter was published in 2016 to answer a critical question for patients, their families, and healthcare providers: When is the best time to begin biologic medications to achieve the best possible outcomes?

Two issues were published and both can be found here.