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Current Research in Rheumatology  


Linking Exercise, Activity, and Pathophysiology in Childhood Arthritis: A Canadian Collaborative Team

JIA (juvenile idiopathic arthritis) is one of the most common chronic diseases occurring in childhood, and can limit an affected child’s/teen’s ability to participate in normal physical activities, sport and play. Low levels of physical activity during growth and development can lead to poor muscle strength, which in turn can affect the ability of growing bones to become as strong as they need to be. The LEAP study is a multi-centre research program, involving 12 Canadian centres, which aims to uncover the factors that affect the ability of children/teens with JIA to participate in physical activities, and the barriers to such participation. We will also examine how varying levels of physical activity affect the inflammation of arthritis, as well as the developing bones and muscles, of children/teens with JIA. Through this research program, we hope to develop new evidence that will support the need for, and promotion of, increased levels of physical activity in children with JIA, with the ultimate objective of improving their overall health and well-being.

Funding Source: The Canadian Institutes of Health Research (CIHR)

UPDATE: A total of 707 families from across Canada have been enrolled into this study. Collection of data is now complete and analysis of data is taking place.

For additional information, please contact the national study coordinator, Michele Gibbon or visit the project website.
The Canadian Alliance of Pediatric Rheumatology Investigators National Juvenile Idiopathic Arthritis Registry (CAPRI JIA Registry)

The purpose of the CAPRI JIA Registry is to collect information on disease course, outcomes and medication adverse events among Canadian children with juvenile idiopathic arthritis (JIA). The registry will use this information to:

1. Provide answers about expected disease outcomes and the risk of medication adverse events for patients and care providers.
2. Contribute to new insights about JIA and its treatment.
3. Allow Canadian researchers to answer their own research questions about JIA.
4. Allow comparison of JIA outcomes and treatments across centres to help improve the healthcare provided to children with JIA.

Funding Source: The Arthritis Society

Update: Enrollment for this Study has begun.

For additional information, please contact the local study coordinator, Michele Gibbon.
The iPeer2Peer Program for Adolescents with Juvenile Idiopathic Arthritis: A Randomized Controlled Trial

For this study, a peer support program for teens with Juvenile Idiopathic Arthritis (JIA) has been developed and will be delivered through the internet using Skype. JIA affects the emotional and physical health of teens as well as relationships with their friends and family. Studies of web-based peer support programs (i.e. programs that use technology to connect similar individuals) for teens with other chronic illnesses have shown that they can improve the teen’s quality of life. We do not know if this peer support program will improve the quality of life of teens with JIA. This study, therefore, is testing it to see if it will make a difference in the management of JIA in teens.

Funding Source: The Arthritis Society

Update: Enrollment for this study has begun.

For additional information, please contact the local study coordinator, Michele Gibbon.

word cloud for arthritis
Translating Research into Practice: Identifying Factors that Influence the Uptake of Canadian Research Findings into the Clinical Care of Children with Arthritis

The objective of this study is to gain a rich understanding of how children with JIA and their parents acquire new information on JIA, including the barriers they face when seeking this information, the information they feel is most important and useful to them, and their awareness and attitudes towards research. We hope that this will help us to get new research information about JIA to patients and their families, in a quick and easy way in the future. For this study, we have been conducting focus group interviews of: (1) teens with JIA and (2) parents of teens with JIA. Focus groups are often used in order to obtain detailed information on the perceptions, insights, attitudes, experiences, or beliefs from a group of people about a particular question or issue. The focus groups are being conducted at 4 Canadian centres.

Funding Source: The Canadian Rheumatology Association, Canadian Initiative for Outcomes in Rheumatology cAre (CIORA) Grant

UPDATE: Collection of data is complete and analysis of data is ongoing.

For additional information, please contact the local study coordinator, Michele Gibbon.
RACER (Readiness for Adult Care in Rheumatology) Questionnaire: Reliability and Validity Testing in Youth with Juvenile Idiopathic Arthritis (JIA)

The goal of this study is to test the RACER (Readiness for Adult Care in Rheumatology) Questionnaire, which has been created to measure patient readiness to transition from paediatric to adult care. This study is taking place at 10 different paediatric and adult centres across Canada (including CHEO), with an expected total of 142 individuals who have a diagnosis of Juvenile Idiopathic Arthritis (JIA) and range in age from 16 to 20 years (at the time of enrolment) taking part. We hope that the RACER questionnaire will be used to assist youth in making a smoother transition from paediatric to adult care, by ensuring that they are ready and prepared. Evaluating transition readiness may lead to less adolescents becoming lost in the transition process and has the potential for positive long-term implications over their lifetimes, including the reduction of future pain and work-related disability and better health outcomes.

Funding Source: Health Research Foundation (HRF)

UPDATE: Enrollment for this study is complete. Follow-up data is being collected.

For additional information , please contact the local study coordinator, Michele Gibbon.

Pediatric Vasculitis Initiative (PedVas): Chronic Childhood Vasculitis: Characterizing the Individual Rare Diseases to Improve Patient Outcomes

Childhood chronic vasculitis is a group of rare diseases that involve the inflammation of blood vessels in important body organs such as the kidneys, lungs and brain. It affects less than 1 in 100 of children/teens under the age of 17 years, annually. Most of what we know about chronic vasculitis in children is based on research involving people who have been diagnosed with vasculitis as adults. Unfortunately this knowledge has limited usefulness in helping children/teens with vasculitis since we don’t know if vasculitis and its treatment affects adults and children/teens in the same way. Doctors may only see one new child/teen with any vasculitis each year, so it is very difficult to learn more about the disease and improve the quality of care that we provide to patients and families dealing with this disease. Through this study, we hope to better understand the differences between adult Vasculitis and childhood Vasculitis in order to improve treatment for children/teens who are living with this disease. To do this, we are studying a large number of adult and paediatric patients with vasculitis, from centres across Canada, as well as other centres in North and South America, Africa, Europe and Asia. Our goal is to have a total of 600 children/teens with Vasculitis participate in this study.

Funding Source: The Canadian Institutes of Health Research (CIHR)

UPDATE: Enrollment for this study is ongoing.

For additional information, please contact the local study coordinator, Michele Gibbon.
The Biologic Basis of Co-existent Uveitis and Arthritis in Children: Towards Early Detection, Targeted Treatment, and Prevention (Plain Language Title: Research to Help Explain Why Children with Arthritis Can Also Have Inflammation of the Eye)

Juvenile idiopathic arthritis (JIA) is among the most common chronic diseases of childhood, affecting about 1 in 1,000 Canadian children/adolescents (the word “idiopathic” means that the cause is unknown). Approximately 8 out of every 100 children/adolescents with JIA will also have associated inflammation in the eye, a condition called uveitis (the cause of uveitis is also unknown). In this study we expect to: (1) explain how collagen (which is a protein normally present in both the joint and the eye), plays a role in causing JIA-uveitis when its structure is changed by certain other proteins involved in inflammation; (2) show that children/adolescents with a certain type of genetic make-up are more likely to have both joint and eye inflammation; (3) explain why girls, with a young onset age of JIA and a positive ANA test are at greatest risk for developing JIA-uveitis; (4) study if a common infection called streptococcus (the same bacteria that causes strep throat) might be a factor that triggers JIA-uveitis in some children. This research is expected to identify a collection of patient features, blood tests and genetic markers that, when combined together, will help predict which children/adolescents will develop JIA-uveitis, the outcomes, and how they will respond to treatment.

Funding Source: The Arthritis Society

UPDATE: Enrollment will begin shortly.

For additional information, please contact the local study coordinator, Michele Gibbon. 
Developing a mobile app to help teenagers with arthritis and their parents make informed and personalized decisions about pain management options

The goal of this research is to develop and evaluate the impact of a mobile app that will give information on various pain management options as well as help families choose the options that reflect their values and preferences. First, the research team reviewed the available evidence on the pain management options for juvenile arthritis. This evidence was integrated into the app. Next, experts in pain and juvenile arthritis, teenagers with arthritis as well as parents participated in consensus meetings to refine the content of the app. The app is now being developed with the help of teenagers with arthritis, their parents and health providers. When the app is developed, we will evaluate whether it is acceptable to teenagers and their families, and whether it is feasible to evaluate through the conduct of a pilot study. Future steps will include a larger study to determine the impact of the tool, and a study to implement it in practice.

Funding Source: The Arthritis Society

UPDATE: Enrollment for this study began in the summer of 2017 and is ongoing.

For additional information, please contact the principal investigator, Karine Toupin April, or the local study coordinator, Tania El Hindi.
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