@article{3203596,
    title = "Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use.",
    author = "van Straalen, Joeri W. and Krol, Roline M. and Giancane, Gabriella and Panaviene, Violeta and Ailioaie, Laura Marinela and Doležalová, Pavla and Cattalini, Marco and Susic, Gordana and Sztajnbok, Flavio and Maritsi, Despoina and Constantin, Tamas and Sawhney, Sujata and Rygg, Marite and Oliveira, Sheila Knupp and Nordal, Ellen Berit and Saad-Magalhaes, Claudia and Rubio-Perez, Nadina and Jelusic, Marija and de Roock, Sytze and Wulffraat, Nico M. and Ruperto, Nicolino and Swart, Joost F.",
    journal = "Rheumatology (Oxford, England)",
    year = "2021",
    pages = "keab678",
    doi = "10.1093/rheumatology/keab678",
    keywords = "inflammatory bowel disease, enthesitis-related arthritis, etanercept, juvenile idiopathic arthritis",
    abstract = "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."
}