Τίτλος:
Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use.
Περίληψη:
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.
Συγγραφείς:
van Straalen, Joeri W.
Krol, Roline M.
Giancane, Gabriella
Panaviene, Violeta
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.
Περιοδικό:
Rheumatology (Oxford, England)
Λέξεις-κλειδιά:
inflammatory bowel disease, enthesitis-related arthritis, etanercept, juvenile idiopathic arthritis
DOI:
10.1093/rheumatology/keab678
