Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use /

Joeri W van Straalen; Roline M Krol; Gabriella Giancane; Violeta Vladislava Panavienė; Laura Marinela Ailioaie; Pavla Doležalová; Marco Cattalini; Gordana Susic; Flavio Sztajnbok; Despoina Maritsi; Tamas Constantin; Sujata Sawhney; Marite Rygg; Sheila Knupp Oliveira; Ellen Berit Nordal; Claudia Saad-Magalhaes; Nadina Rubio-Perez; Marija Jelusic; Sytze de Roock; Nico M Wulffraat; Nicolino Ruperto; Joost F Swart

doi:10.1093/rheumatology/keab678

Title	Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use /
Authors	van Straalen, Joeri W ; Krol, Roline M ; Giancane, Gabriella ; Panavienė, Violeta Vladislava ; Ailioaie, Laura Marinela ; Doležalová, Pavla ; Cattalini, Marco ; Susic, Gordana ; Sztajnbok, Flavio ; Maritsi, Despoina ; Constantin, Tamas ; Sawhney, Sujata ; Rygg, Marite ; Oliveira, Sheila Knupp ; Nordal, Ellen Berit ; Saad-Magalhaes, Claudia ; Rubio-Perez, Nadina ; Jelusic, Marija ; de Roock, Sytze ; Wulffraat, Nico M ; Ruperto, Nicolino ; Swart, Joost F
DOI	10.1093/rheumatology/keab678
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Is Part of	Rheumatology.. Oxford : Oxford University Press. 2022, vol. 61, no. 5, p. 2104-2112.. ISSN 1462-0324. eISSN 1462-0332
Keywords [eng]	enthesitis-related arthritis ; etanercept ; inflammatory bowel disease ; juvenile idiopathic arthritis
Abstract [eng]	OBJECTIVES: To describe risk factors for inflammatory bowel disease (IBD) development in a cohort of children with juvenile idiopathic arthritis (JIA). METHODS: JIA patients who developed IBD were identified from the international Pharmachild register. Characteristics were compared between IBD and non-IBD patients and predictors of IBD were determined using multivariable logistic regression analysis. Incidence rates of IBD events on different disease-modifying anti-rheumatic drugs (DMARDs) were calculated, differences between therapies were expressed as relative risks (RR). RESULTS: Out of 8,942 patients, 48 (0.05%) developed IBD. These were more often male (47.9% vs 32.0%) and HLA-B27 positive (38.2% vs 21.0%) and older at JIA onset (median 8.94 vs 5.33 years) than patients without IBD development. They also had more often a family history of autoimmune disease (42.6% vs 24.4%) and enthesitis-related arthritis (ERA) (39.6% vs 10.8%). The strongest predictors of IBD on multivariable analysis were ERA (OR: 3.68, 95% CI: 1.41-9.40) and a family history of autoimmune disease (OR: 2.27, 95% CI: 1.12-4.54). Compared with methotrexate monotherapy, the incidence of IBD on etanercept monotherapy (RR: 7.69, 95% CI: 1.99-29.74), etanercept with methotrexate (RR: 5.70, 95% CI: 1.42-22.77) and infliximab (RR: 7.61, 95% CI: 1.27-45.57) therapy was significantly higher. Incidence on adalimumab was not significantly different (RR: 1.45, 95% CI: 0.15-13.89). CONCLUSION: IBD in JIA was associated with ERA and a family history of autoimmune disease. An increased IBD incidence was observed for etanercept therapy regardless of concomitant methotrexate use.
Published	Oxford : Oxford University Press
Type	Journal article
Language	English
Publication date	2022
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„Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use /“