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Autoimmune & Inflammatory

Systemic Juvenile Idiopathic Arthritis (AOSD) Clinical Trials

Also called sJIA, Still's disease, systemic JIA, systemic onset JIA, adult-onset Still's disease, AOSD, Still disease

Systemic juvenile idiopathic arthritis is fundamentally different from other forms of JIA. While polyarticular and oligoarticular JIA are autoimmune conditions driven by adaptive immunity (T cells, autoantibodies), sJIA is classified as an autoinflammatory disease driven by innate immune cells, particularly monocytes and macrophages, that overproduce interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and interleukin-18 (IL-18).

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About Systemic Juvenile Idiopathic Arthritis

Systemic juvenile idiopathic arthritis is fundamentally different from other forms of JIA. While polyarticular and oligoarticular JIA are autoimmune conditions driven by adaptive immunity (T cells, autoantibodies), sJIA is classified as an autoinflammatory disease driven by innate immune cells, particularly monocytes and macrophages, that overproduce interleukin-1 beta (IL-1β), interleukin-6 (IL-6), and interleukin-18 (IL-18).

The disease course is heterogeneous. About 30 to 40% of patients have a monocyclic course (one episode that resolves), fewer than 10% follow a polycyclic relapsing pattern, and over half develop persistent disease with chronic joint destruction. The most feared complication is macrophage activation syndrome (MAS), which occurs in 10 to 15% of sJIA patients (and subclinically in up to 30 to 40%) and involves uncontrolled activation of macrophages and T cells, causing a cytokine storm with high ferritin, coagulopathy, liver failure, and multi-organ dysfunction. MAS can be fatal without rapid treatment.

Treatment has been transformed by biologic therapies targeting IL-1 and IL-6. Canakinumab (Ilaris, anti-IL-1β) and tocilizumab (Actemra, anti-IL-6R) are both FDA-approved for sJIA and achieve rapid disease control in the majority of patients. In June 2025, emapalumab (Gamifant) was approved for MAS in the context of sJIA, providing the first targeted therapy for this life-threatening complication.

Common Symptoms of Systemic Juvenile Idiopathic Arthritis

Recognizing the signs of Systemic Juvenile Idiopathic Arthritis early can lead to faster diagnosis and better outcomes. Symptoms may vary in severity from person to person. If you or a loved one are experiencing any of the following, consider speaking with a specialist.

  • Daily high-spiking fevers (often 39°C/102°F or higher) with a quotidian pattern, peaking in afternoons or evenings
  • Salmon-pink, flat, transient rash that appears with fevers and fades when temperature normalizes
  • Joint swelling and pain, often involving wrists, knees, and ankles
  • Enlarged liver and spleen (hepatosplenomegaly)
  • Inflammation of the heart or lung lining (pericarditis, pleuritis)
  • Lymph node swelling and elevated inflammatory markers (ferritin, ESR, CRP)

Who Systemic Juvenile Idiopathic Arthritis Affects

Typically presents around age 2 years, though onset can occur at any age through adolescence. The adult equivalent (adult-onset Still's disease) has a bimodal onset, peaking at ages 15 to 25 and again at 36 to 46.

Affects boys and girls equally, which distinguishes it from other JIA subtypes that have a female predominance. All ethnicities affected.

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FDA-Approved Treatments for Systemic Juvenile Idiopathic Arthritis

There are currently 4 FDA-approved medications for Systemic Juvenile Idiopathic Arthritis. These therapies represent the current standard of care and may be used alongside or compared against investigational treatments in active clinical trials.

canakinumab
Novartis
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tocilizumab
Genentech / Roche
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anakinra
Sobi (Swedish Orphan Biovitrum)
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emapalumab
Sobi (Swedish Orphan Biovitrum)
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Source: openFDA drug labeling data. This list may not include all treatments. Always consult your doctor.

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Help Paying for Systemic Juvenile Idiopathic Arthritis Treatment

Charity funds and drugmaker programs for Systemic Juvenile Idiopathic Arthritis, checked at the source. Pick your insurance to see what fits.

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Charity funds
  • From a charity · The Assistance Fund
    Juvenile Arthritis fund
    Waitlist

    Pays for: Copays, coinsurance, deductibles and other health-related expenses.

    The foundation says: “WAITLIST — Accepting Waitlist Patients. TAF is currently accepting requests to join the enrollment waitlist for this program. Waitlists a…”
Status as each foundation showed it on September 28, 2026.

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Side Effect Explorer

Real-world side effect reports from the FDA Adverse Event Reporting System (FAERS). Includes both FDA-approved drugs and investigational therapies from active clinical trials. Click any drug to see what patients reported.

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Genetic Testing

Genetic testing can confirm a diagnosis, guide treatment decisions, and identify family members who may be at risk.

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Trusted Systemic Juvenile Idiopathic Arthritis Resources

Reputable organizations and medical references for learning more about Systemic Juvenile Idiopathic Arthritis, including disease registries, foundation resources, and clinical guidelines.

Active Clinical Trials for Systemic Juvenile Idiopathic Arthritis

Use this Systemic Juvenile Idiopathic Arthritis clinical trial finder to see the 20 studies recruiting patients and 7 opening soon in the United States and worldwide, with eligibility criteria in plain English. These studies play a critical role in advancing care for autoimmune & inflammatory conditions and may offer access to treatments not yet widely available. Each trial below is sourced directly from ClinicalTrials.gov, with eligibility criteria translated into plain English to help patients and caregivers evaluate whether a study may be a fit.

TrialsSite mapPipeline timeline

Note: Trial recruitment statuses on ClinicalTrials.gov may not immediately reflect recent FDA decisions, sponsor announcements, or enrollment changes. Always confirm a trial's current status directly with the study coordinator before making plans.

27 active trials worldwide
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RECRUITINGRecently updatedNCT07845942

Allogeneic Hematopoietic Cell Transplantation for Refractory Systemic Juvenile Idiopathic Arthritis.

Sponsor: Children's Hospital Medical Center, Cincinnati

The goal of this study is to collect clinical data and samples and to evaluate the feasibility of allogeneic hematopoietic cell transplantation (HCT) in children and young adults with refractory Systemic Juvenile Idiopathic Arthritis (sJIA), including those with sJIA-associated lung disease (sJIA-LD).

Ages up to 35 Years1 location
Started Nov 2026Updated todayEst. Jul 2031 (~4y 10m)
RECRUITINGPHASE2Recently updatedNCT07203001

A Phase II Trial to Evaluate the Clinical Efficacy, Safety and Tolerability of MAS825 in Pediatric and Adult Participants With Still's Disease

Intervention: MAS825

Sponsor: Novartis Pharmaceuticals

The study is a phase II trial designed to evaluate the clinical efficacy, safety, and tolerability of MAS825 (arumakimig) in pediatric and adult participants with Still's disease

Ages 1 Year+23 locations
Started Nov 2025Updated 4 days agoEst. Apr 2027 (~6 months)
RECRUITINGRecently updatedNCT03510442

Natural History, Genetics, and Pathophysiology of Systemic Juvenile Idiopathic Arthritis, Adult-Onset Still's Disease, and Related Conditions

Sponsor: National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)

Background:

Ages 1 Day – 100 Years1 location
Started May 2018Updated 4 days agoEst. Jan 2050 (~23y 3m)
RECRUITINGPHASE2Recently updatedNCT02991469

A Repeated Dose-finding Study of Sarilumab in Children and Adolescents With Systemic Juvenile Idiopathic Arthritis (SKYPS)

Intervention: Sarilumab SAR153191 (REGN88)

Sponsor: Sanofi · Regeneron Pharmaceuticals

Primary Objective:

To describe the pharmacokinetic (PK) profile of sarilumab in patients aged 1-17 years with Systemic Juvenile Idiopathic Arthritis (sJIA) in order to identify the dose and regimen for adequate treatment of this population.

Secondary Objective:

Ages 1 Year – 17 Years37 locations
Started Aug 2018Updated 6 days agoEst. Mar 2028 (~1y 5m)
RECRUITINGPHASE3Recently updatedNCT03773965

A Study of Baricitinib in Participants From 1 Year to Less Than 18 Years Old With Juvenile Idiopathic Arthritis

Intervention: Baricitinib

Sponsor: Eli Lilly and Company

The reason for this study is to see if the study drug baricitinib is safe and effective in the treatment of JIA in participants ages 1 to 17. This study is for participants that have been enrolled in studies I4V-MC-JAHV (NCT03773978) or I4V-MC-JAHU.

Ages 1 Year – 18 Years78 locations
Started Apr 2019Updated 1 week agoEst. Jul 2031 (~4y 10m)
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Active trial locations11 cities in the US
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Trial Pipeline

Jan 2021 to Sep 2031
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Data from ClinicalTrials.gov, U.S. National Library of Medicine.
Always talk to your doctor before considering a clinical trial.

Patient Communities

Connect with other Systemic Juvenile Idiopathic Arthritis patients, caregivers, and advocacy groups across Facebook groups, Reddit communities, and YouTube channels. These patient communities offer peer support, shared experiences, caregiver resources, and real-time discussion about Systemic Juvenile Idiopathic Arthritis treatments, clinical trial participation, and day-to-day disease management.

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Related Autoimmune & Inflammatory Conditions

Other rare diseases in the autoimmune & inflammatory category. Patients with Systemic Juvenile Idiopathic Arthritis may find relevant research, shared treatment pathways, or overlapping clinical trials among these related conditions.

Companies Developing Systemic Juvenile Idiopathic Arthritis Treatments

6 pharmaceutical companies have Systemic Juvenile Idiopathic Arthritis in their rare disease portfolio

Frequently Asked Questions About Systemic Juvenile Idiopathic Arthritis