New Results from Long-Term Study Show Early Use of Biologics Improves Outcomes for Children with Polyarticular Juvenile Idiopathic Arthritis

WASHINGTON, Oct. 3, 2025 /PRNewswire/ -- There are new long-term results from a landmark study using the CARRA Registry that looks at when to start biologics in children diagnosed with Polyarticular Juvenile Idiopathic Arthritis (poly JIA) comparing the CARRA Consensus Treatment Plans (CTPs).

After following nearly 300 children with poly JIA in the CARRA Registry for three years, researchers discovered that patients who started the Early Combination CTP (biologics and methotrexate together) have better outcomes and spent more time in inactive disease than those who received the Step-Up CTP, which starts with methotrexate alone and adds a biologic later if needed. A separate analysis of the study found that patients who start biologics very early (by two months) have the best disease trajectory. The results were recently published in Arthritis & Rheumatology.

"These findings demonstrate that early treatment with effective therapies is critical for children with poly JIA," said Principal Investigator Yukiko Kimura, M.D. "By starting biologics earlier, we may be able to significantly improve long-term outcomes. Induction with early biologic therapy can be used in combination with treat-to-target approaches once inactive disease is achieved."

The study is known as STOP-JIA (Start Time Optimization of biologics in Polyarticular Juvenile Idiopathic Arthritis consensus treatment plans study). Consensus Treatment Plans (CTPs) are a specific set of treatment options that were developed based on both literature review and agreement among family and health care providers of children with rheumatic diseases.

Developed by CARRA, CTPs helped lay the groundwork for STOP-JIA and other key studies. CTPs make it possible to conduct comparative effectiveness research using an observational approach through the CARRA Registry, which makes enrolling large numbers of patients feasible, such as was done for STOP-JIA. By narrowing treatment approaches and then studying how patients respond to each treatment option, physicians can better identify which treatment may be most effective.

STOP‐JIA, which was the first study to use this novel approach to comparative effectiveness research, received funding from the Patient-Centered Outcomes Research Institute (PCORI).

"The latest results show that starting biologics within two months predicts rapid improvement and an improved ability to maintain inactive disease, supporting our hypothesis that early initiation of biologics can reduce the overall disease burden in children with poly JIA," said Laura E. Schanberg, M.D., co-PI of the study. "The results also suggest that the initial use of a treat-to-target approach may not yield optimal outcomes."

Poly JIA, which is an autoimmune disease, is a type of juvenile idiopathic arthritis that affects five or more joints.

The CARRA Registry is the largest ongoing observational registry in North America that collects clinical and patient-reported information about children and young adults with pediatric-onset rheumatic diseases. Launched in 2015, it now has more than 70 sites in the United States and Canada and has enrolled more than 15,500 participants. The registry enrolls participants with juvenile idiopathic arthritis, lupus, and dermatomyositis, as well as collects patient samples (e.g. blood) across 19 cohorts for a biorepository.

STOP-JIA illustrates the unique value of the CARRA Registry as a comprehensive data source of clinical and patient-reported information that helps researchers answer critical questions that patients and providers have, conduct comparative effectiveness research, inform treatment decisions, and ultimately improve outcomes for children with rheumatic diseases.

"This landmark study underscores CARRA's leadership in pediatric rheumatology and highlights the impact our collaborative research is having on clinical care," said Stacy Ardoin, M.D., CARRA president. "STOP-JIA is one of many ways that CARRA is driving progress toward better outcomes for our patients."

Patients and caregivers helped guide STOP-JIA through the Stakeholder Advisory Panel. Vincent Del Gaizo, co-leader of the Stakeholder Advisory Panel and the parent of a child who has JIA, also serves as an investigator on the core study team, and helped develop the study, select outcomes, create recruitment materials, and train sites. 

"STOP-JIA is a prime example of how CARRA brings together diverse stakeholders to conduct collaborative research and answer the questions that matter most to patients and their families," said Del Gaizo, Director of Partnerships and Engagement at CARRA.

About the Childhood Arthritis and Rheumatology Research Alliance (CARRA):
CARRA's mission is to conduct collaborative research to prevent, treat, and cure pediatric rheumatic diseases. Formed in 2002 by a small group of dedicated physicians, CARRA now has more than 800 members at over 120 institutions. CARRA has built the largest observational multi-center registry for pediatric rheumatic disease and operates two biorepositories – one in the US and one in Canada. CARRA is a 501(c)3 registered non-profit. Learn more at carragroup.org.

Media Contact:
Erin Moriarty Wade
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SOURCE Childhood Arthritis and Rheumatology Research Alliance (CARRA)