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 study has been created to answer these important questions.

Who can take part?

We are inviting children, teenagers, and young adults (up to the age of 21) who:

  • Have oligoarticular JIA or seronegative polyarticular JIA (you can check this with your arthritis doctor)
  • Have been taking methotrexate for at least 12 months
  • Have had inactive or minimal disease activity for at least 12 months
  • Are willing to continue regular check-ins with their rheumatology team
  • Have been off certain other treatments, not had joint injections in the past 12 months, not having active eye disease (uveitis)

What does the study involve?

1. Consenting to A3BC and CHAMPION-MTX studies
To join CHAMPION-MTX, we also ask you to join A3BC. This is because CHAMPION-MTX is a partner study of the A3BC study.

2. A short “observation” period (3 months)
Everyone stays on their usual methotrexate dose while we confirm their arthritis remains controlled.

3. Randomisation (like flipping a coin)
After the observation 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 half for 6 months, then stopped completely.

Neither approach is known to be better, that’s what we are trying to find out.

4. Regular check ins
Participants attend follow up visits every 3 months, which will occur during your usual clinic visits. These could sometimes be phone visits instead.

These visits monitor:

  • Joint symptoms
  • General well-being
  • Any flare-ups
  • Medication changes
  • Quality of life and well-being questionnaires

As part of your A3BC participation, you can choose to provide optional blood, stool and/or oral swab samples to help researchers understand biological markers of JIA.

Below is a summary of visits:

How long does participation last?

  • If you stop methotrexate straight away, your participation is 12 months
  • If you taper first, your participation will be 18 months (6 months of reduced MTX dose, followed by 12 months follow up)

After finishing, you may also choose to continue to participate in A3BC, but this is completely voluntary.

Why is this research important?

Families and doctors want to know:

  • Who can safely reduce or stop methotrexate
  • Is tapering safer than stopping suddenly?
  • What early warning signs predict a flare and how many participants will flare?
  • Are there blood markers that can guide treatment to suit the individual participant/future patients with these conditions?
  • What are the financial costs, life disruptions, health, and emotional impacts of each approach?

This study is the first in Australia, and one of only a 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 rheumatology team will continue to care for you.
If you have a flare or have any health concerns, treatment will be guided by your doctor — your health always comes first.

Are there any costs or payments?

There is no cost to join CHAMPION-MTX.
To compensate you for some of your out-of-pocket expenses while you are in CHAMPION-MTX, we will provide you with a gift card.
Travel costs and clinical care remain the same as usual depending on your usual clinic/hospital attendance.

Who is running the study?

CHAMPION-MTX is led by rheumatologists and researchers across Australia, including:

  • The University of Sydney and the A3BC Headquarters team
  • Major children’s hospitals and rheumatology clinics nationwide
  • The Australian Arthritis and Autoimmune Biobank Collaborative (A3BC) who are located across Australia
    It is funded by the Australian Government’s Medical Research Future Fund.

Interested in participating (or for your child)?

As of August 2026, CHAMPION-MTX has not yet commenced enrolling participants. This page will be updated with further details once enrolment is open.
In the meantime, if you are under 21 years and have JIA or your own child under 18 has JIA and would like to find out more, please speak to your rheumatologist first. They can explain CHAMPION-MTX, answer questions, and help you decide if joining is right for you and if their clinic is open for enrolment.

Further information

CHAMPION-MTX Participant Study Information (Web Content) v1.0 22-May-2026