Juvenile idiopathic arthritis (juvenile rheumatoid arthritis)
Research & Innovation
Even as researchers are working to discover the cause of juvenile idiopathic arthritis, progress in treating JIA is moving faster than ever. Just a few decades ago, doctors could do little to actually change the course of the disease: While aspirin could ease the symptoms or steroids could tamp down inflammation (with often-risky side effects), there wasn’t much by way of a long-term solution. Today, however, there are many more therapies -- with fewer side effects -- to effectively control inflammation and avoid the consequences of this once-devastating disease.
Children’s Hospital Boston physicians are helping pioneer some of the most promising new treatments for JIA, including the use of biologics, protein-based drugs made from living cells cultured in a lab. In arthritis, the immune system is mistakenly attacking healthy tissue (in this case, the lining of the joints). Many medications therefore work to slow down -- suppress -- the whole immune system. But a biologic drug is different, because it targets specific parts of the immune system in order to “block” their role in causing joint inflammation.
Children’s rheumatologist Peter Nigrovic, MD, recently took a closer look at one of these biologics, anakinra. Anakinra is one of a group of biologics that target interleukin-1, a kind of “messenger molecule” that carries information from one group of immune cells to another. In a report that drew on data from 11 treatment centers worldwide, Nigrovic and his colleagues examined how well anakinra worked for children with the most serious form of JIA, called systemic JIA. Among the highlights:
- 22 percent of the children received only anakinra.
- Of the others, 67 percent also received corticosteroids and 33 percent received additional disease-modifying anti-rheumatic drugs (DMARDs).
- At the time of follow-up, about 90 percent of all children had seen their arthritis go into remission.
- Among those who had full remission were 80 percent of the children who received only anakinra.
The report suggests that with further study, interleukin-1 blockers like anakinra could prove to be a powerful first line of defense against systemic JIA.
Clinical trials and patient registries
There are many ways in which your child might benefit from Children’s Hospital Boston’s medical research program. Children’s doctors and scientists have made many breakthrough discoveries about diseases like polio and leukemia; our ongoing research continues to push the boundaries of the way pediatric medicine is practiced.
It’s possible that your child will be eligible to participate in one of Children’s current clinical trials. These studies are useful for a multitude of reasons: Some trials are designed to evaluate the effectiveness of a particular drug, treatment or therapy on a specific disease; others help doctors to better understand how and why certain conditions occur. At any given time, Children’s has hundreds of clinical trials under way.
Alternately, your child’s doctor might ask you to participate in a registry, a list of patients with JIA that is matched to an archive of biospecimens (such as serum and DNA) to serve as a resource for research into this disease.
And participation in any clinical trial or registry is completely voluntary: We will take care to fully explain all elements of the treatment plan prior to the start of the trial, and you may remove your child from the medical study at any time.
|Clinical and Translational Study Unit|
|Read about a day in the life of the Clinical and Translational Study Unit at Children’s.|