Our aims:

To compare two different steroid treatments in children and young people with childhood onset arthritis (known as juvenile idiopathic arthritis; JIA) to find out which is best.

Background:

JIA can cause significant pain and joint stiffness which can have a major impact on daily life and education. It is important to treat quickly and effectively to ensure that children and young people can return to normal activity and to prevent long-term joint damage. Medications used for long-term control take around 12 weeks to start working. In contrast, steroids act quickly and are used to switch off inflammation whilst the other medications start to work. Steroids are therefore key to the treatment of new-onset arthritis.

Despite the benefit of steroids, children and young people tell us they find side-effects difficult. There are no studies comparing giving steroids by tablet versus via a drip. We don't know which is best and which is most acceptable to patients and their caregivers.

Design & Methods:

Children and young people aged 1-16 years old who have been newly diagnosed with JIA and with at least 5 inflamed joints will be invited to take part. They will be randomised to either:

Both types of steroid are given regularly in the UK to treat JIA. Children and young people will receive standard care for JIA, including methotrexate. The difference in taking part in the study compared to standard care is that the choice of steroid will be selected by random. There will also be some extra assessments.