CHAMPION-MTX
What is this study about?
Many children and young people with juvenile idiopathic arthritis (JIA) take methotrexate (MTX) to control inflammation and keep their arthritis quiet.
Once their disease becomes stable and inactive, families and doctors often wonder:
- “Can we reduce the methotrexate dose?”
- “Is it safe to stop it completely?”
- “What is the best way to do this?”
Right now, there is no clear evidence to guide these decisions.
The CHAMPION‑MTX Trial has been created to answer these important questions.
Who can take part?
We are inviting children, teenagers, and young adults (up to age 21) who:
- Have oligoarticular JIA or seronegative polyarticular JIA
- Have been taking methotrexate for at least 12 months
- Have had inactive or very low disease activity for at least a year
- Are willing to continue regular check-ins with their paediatric rheumatology team
What does the study involve?
1. A short “run‑in” period (3 months)
Everyone stays on their usual methotrexate dose while we confirm their arthritis remains controlled.
2. Randomisation (like flipping a coin)
After the run‑in period, participants are placed into one of two groups:
Group 1 – “STOP” methotrexate
You stop methotrexate completely at the first study visit.
Group 2 – “TAPER” methotrexate
Your methotrexate dose is reduced by 50% for 6 months, then stopped completely.
Neither approach is known to be better, that’s what we are trying to find out.
3. Regular check‑ins
Participants attend follow‑up visits every 3 months, which usually line up with routine clinic appointments.
These visits monitor:
- Joint symptoms
- General well-being
- Any flare-ups
- Medication changes
- Quality‑of‑life and well-being questionnaires
You can choose to provide optional blood, stool, or oral swab samples to help researchers understand biological markers of flare.
How long does participation last?
- If you stop methotrexate straight away: 12 months of follow‑up
- If you taper first: 18 months of follow‑up
After finishing, you may also choose to join an optional long‑term follow‑up program (A3BC), but this is completely voluntary.
Why is this research important?
Families and clinicians want to know:
- Who can safely reduce or stop methotrexate?
- Is tapering safer than stopping suddenly?
- What early warning signs predict a flare?
- Are there biological markers that can guide personalised treatment?
- What are the cost, health, and emotional impacts of each approach?
This trial is the first in Australia, and one of the few worldwide, to carefully compare these strategies in children and young adults with JIA.
The results will help improve care for future patients and support confident, evidence‑based decision‑making.
Will taking part change my usual care?
Your regular paediatric rheumatology team will continue to care for you.
If you flare or have any health concerns, treatment will be guided by your doctor — your health always comes first.
Are there any costs or payments?
Taking part is free.
To thank you for your time, you can receive small gift card reimbursements (e.g., for visits and questionnaires).
Travel costs and clinical care remain the same as usual.
Who is running the study?
The trial is led by paediatric rheumatologists and researchers across Australia, including:
- The University of Sydney
- Major children’s hospitals and rheumatology clinics nationwide
- The Australian Arthritis and Autoimmune Biobank Collaborative (A3BC)
It is funded by the Australian Government’s Medical Research Future Fund.
Interested in participating?
As of April 2026, the study has not yet commenced enrolling participants. This page will be updated with further details once enrolment is open.
In the meantime if you or your child has JIA and would like to find out more, please speak to your paediatric rheumatologist first. They can explain the study, answer questions, and help you decide if joining is right for you.