Applicability of standardized ultrasound examination to estimate disease activity in combination with JADAS and inflammation markers in JIA patients


This multicenter, international longitudinal study will recruit JIA patients (according to ILAR classification criteria) with active disease according to JADAS 10 and 27 scoring prior starting recommended treatment. All JIA relevant data (demographics, duration, disease activity, medication usage and treatment efficacy) will be collected and parent/guardian written consent obtained.

At enrolment and during predefined scheduled follow up visits (at 3 months up to 12 months) all JIA patients will be clinically evaluated by JADAS 10 and 27 scoring, examined by ultrasound gray-scale (GS) and Power Doppler (PD) in (44 joints) using OMERACT synovitis scoring system by an expert in pediatric ultrasound.

At each visit blood samples will be obtained for evaluation of inflammatory markers (such as cytokines, chemokines and S100A8, S100A9 and S100A12). In the case of disease worsening, the same parameters will be performed as unscheduled visit.

Facts and figures

Project lead
D Lazarevic
Clinic of Pediatrics
FOREUM research grant: € 125.00

Meet the team

D Lazarevic
Clinic of Pediatrics
J Vojinovic
Pediatric Rheumatology Department
C Malattia
Istituto Giannina Gaslini


  • to establish minimal corset of representative joints to be assessed by clinical examination and ultrasound to be used as outcome tool in JIA
  • to investigate if joint findings correlate with the panel of laboratory inflammation markers
  • tо evaluate sensitivity and predictive value of the multi-biomarker panel (clinical examination of the joints, ultrasound and inflammatory biomarkers) in JIA patients
  • to test if multi-biomarker panel could be applied in every day clinical practice to predict response to treatment and outcome tool in JIA
  • to improve possibility to achieve optimized personalized tailored treatment


Month 0-3:
Ethics Committees Approval, ICF and CRF preparation, organization of web based ultrasound calibration exercise
Month 0-12:
Active enrolment of the patients (to be extended if necessary)
Month 12-18:
Longitudinal phase of the study and midterm analysis
Month 18-24:
Termination of the follow up phase
Month 24-27:
Shipment of the blood samples and analysis
Month 27-36:
Statistical analysis and publications

Patient voice

Patient participation from local patient organizations will be crucial to explore which questions of interest have the greatest impact on the patient disease outcomes and treatment response. They should be involved in public engagement and inform wider society using different media if this project meets the needs of JIA patients.

What have we done until now?

  • we have prepared all study documents for Ethics Comittee submission
  • we have obtained Ethics Committee Approval of the home and the host center
  • we have send all necessary study documents to the participating centers
  • we have obtained Ethics Committee Approval of some of the participating centers: Italy, France, Greece and Turkey
  • the other interested participating centers are in the process of getting EC Approvals: Germany, Denmark
  • we have prepared study website, ultrasound educative modules and test for ultrasonographers
  • we have prepared laboratory instructions and lab kits
  • we are about to start activation of participating centers
  • we have screened first three patients in the home center