Childhood arthritis is a chronic disabling disease. New medications called biologic therapies are now available to treat arthritis that target key biologic molecules that cause inflammation. Biologic therapies, while very effective in treating arthritis in children, may have serious side effects including infections and potentially cancers, and are very expensive and doctors don't know, which one to choose for which child. The investigators will develop tests that enable them to learn about the biology of each child's arthritis and be able to predict when and which biologic therapy to start and when to stop.
Eligibility
Sex
ALL
Min age
—
Max age
18 Years
Healthy volunteers
No
Inclusion Criteria:
Cohort 1: - Biologic Basis of JIA
* ≤18 years\*
* Active objective arthritis suspected to be JIA or diagnosed with JIA within 6 months of enrolment
* Treatment naïve except for NSAIDs, allowed to have received NSAIDS within 6 months of diagnosis
Cohort 2 - Start Biologics
* JIA diagnosis as per ILAR criteria (all subtypes)
* ≤18 years\*
* Active arthritis
* For sJIA, active disease not necessarily with arthritis.
* Time of start, restart or switch biologic therapy: e.g. failure, insufficient/partial response or intolerance
Cohort 3 - Stop Biologics
* JIA diagnosis as per ILAR criteria (all subtypes)
* ≤18 years\*
* Inactive disease
* Discontinuing/tapering biologics for inactive disease
Cohort 4: Extreme Phenotypes
* Unexplained systemic inflammation with arthritis/arthralgia as a part of manifestations
* High suspicion of genetic contribution
* Severely affected patients with difficult to control disease (ie failure of multiple biologics)
Exclusion Criteria:
Cohort 1 :
* Arthritis explained by another diagnosis
* Joint injections as previous treatment less than 4 weeks prior to enrollment
Cohort 2:
* Arthritis explained by any other cause
* Start on biologics as an indication for uveitis only
Cohort 3:
\- Tapering scheme \> 12 months to complete biologics stop
Cohort 4:
\- Arthritis explained by another diagnosis
Primary outcome measure(s)
Prospectively collect essential clinical data elements from children with new onset JIA — Up to 24 months
Evaluate clinical outcomes associated with the use of therapeutic agents in children with JIA — Up to 24 months
Evaluate clinical outcomes associated with the de-prescribing of therapeutic agents in children with JIA — Up to 24 months
Prospectively collect essential clinical data elements from children with extreme phenotypes of JIA. — Up to 12 months
Prospectively collect essential biological data elements from children with new onset JIA — Up to 24 months
Evaluate biological outcomes associated with the use of therapeutic agents in children with JIA — Up to 24 months
Evaluate biological outcomes associated with the de-prescribing of therapeutic agents in children with JIA — Up to 24 months
Prospectively collect essential biological data elements from children with extreme phenotypes of JIA — Up to 12 months
Prospectively collect essential socioeconomic data elements from children with new onset JIA — Up to 12 months
Evaluate the socioeconomic impact associated with the use of therapeutic agents in children with JIA — Up to 12 months
Evaluate the socioeconomic impact associated with the de-prescribing of therapeutic agents in children with JIA — Up to 24 months
Prospectively collect essential socioeconomic data elements from children with extreme phenotypes of JIA — Up to 12 months
Trial sites (19)
Facility
City
Region
Status
Alberta Children's Hospital - University of Calgary
Calgary
Alberta
Recruiting
Stollery Children's Hospital
Edmonton
Alberta
Recruiting
BC Children's Hospital
Vancouver
British Columbia
Recruiting
Children's Hospital Health Science Centre Winnipeg
Winnipeg
Manitoba
Recruiting
Janeway Children's Hospital and Rehabilitation Centre
St. John's
Newfoundland and Labrador
Recruiting
IWK Health Centre
Halifax
Nova Scotia
Recruiting
McMaster Children's Hospital
Hamilton
Ontario
Recruiting
Children's Hospital, London Health Sciences Centre
London
Ontario
Recruiting
Children's Hospital of Eastern Ontario
Ottawa
Ontario
Recruiting
The Hospital for Sick Children
Toronto
Ontario
Recruiting
Montréal Children's Hospital
Montreal
Quebec
Recruiting
University of Saskatchewan
Saskatoon
Saskatchewan
Recruiting
Amalia Children's Hospital, Radboudumc
Nijmegen
Gelderland
Recruiting
Sint Maartenskinderkliniek
Boxmeer
North Brabant
Recruiting
Emma Children's Hospital, Amsterdam UMC
Amsterdam
North Holland
Recruiting
Willem-Alexander Children's Hospital, LUMC
Leiden
South Holland
Recruiting
Sophia Children's Hospital, EMC
Rotterdam
South Holland
Recruiting
Beatrix Children's Hospital, UMCG
Groningen
Netherlands
Recruiting
Wilhelmina Children's Hospital, UMCU
Utrecht
Netherlands
Recruiting
More The Hospital for Sick Children trials in the Netherlands
This page summarises publicly available registry data for informational purposes — not medical advice. Eligibility is determined by each study team; patients should discuss participation with their clinician.
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