Development of a living registry of all randomised controlled trials in juvenile idiopathic arthritis

Article type
Authors
Tan J1, Renton W2, Whittle S3, Johnston R4, Arno A4, Horrigan D5, Buchbinder R4
1Women's & Children's Hospital Network / SA Health / Monash University
2Royal Children's Hospital / Monash Children's Hospital / Monash University
3Queen Elizabeth Hospital / SA Health / Monash University
4Monash University
5Monash University/Cabrini Health
Abstract
Background:
Juvenile idiopathic arthritis (JIA) is the most common rheumatic inflammatory disorder in childhood. Despite this, high-quality randomised controlled trials (RCTs) relevant to JIA are relatively sparse. Systematic searches for RCT evidence are time-consuming and can limit efficient review and guideline development.

Objectives:
To develop and maintain a living registry of all completed or in-progress RCTs and quasi-RCTs that include patients with a diagnosis of JIA to aid in the development of living systematic reviews and guidelines.

Methods:
We included all RCTs and quasi-RCTs involving participants with JIA regardless of intervention. MEDLINE, Embase, the Cochrane Central Register of Controlled Trials (CENTRAL), ClinicalTrials.org and the World Health Organization (WHO) International Clinical Trials Registry Platform were searched from inception on 8 March 2021. Machine learning and crowdsourcing were used to identify probable RCTs from the initial search. Two independent authors further screened the search results to identify potentially relevant studies for full text review. For each included trial, we extracted population, interventions, comparisons and any study identifiers recorded in registries. To maintain the registry in living mode, four further searches have been run to date (10 Nov 2021 and 13 April, 13 July and 12 October 2022).

Results:
The initial search yielded 5739 records, and 218 trials were included. An additional eight, eight, three, and nine new trials were identified in subsequent searches (total currently of 246 unique trials [540 records]). An additional 38 records are awaiting assessment. Of the included trials, 153 have published results, 27 have conference abstracts only and 66 have a published protocol but no published results to date. The most studied interventions are medications (n=109) followed by physical therapies (n=32), psychological therapies (n=19,) diet/probiotics (n=6), surgery (n=1) and other (n=6).

Conclusions:
Our living repository of all JIA RCTs will provide an ongoing resource for keeping our living reviews and guideline recommendations for the management of JIA up to date. It will also be useful for identifying evidence gaps.

Patient, public and/or healthcare consumer involvement:
This repository will be used for the development of living clinical guidelines for the management of JIA.