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

Autor:	van Straalen JW; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands., Krol RM; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands., Giancane G; Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini.; Dipartimento di Neuroscienze, Riabilitazione, Oftalmologia, Genetica e Scienze Materno-Infantili (DiNOGMI), Università degli Studi di Genova, Genoa, Italy., Panaviene V; Children's Hospital, Affiliate of Vilnius University Hospital Santaros Clinic.; Clinic of Children's Diseases, Vilnius University, Vilnius, Lithuania., Ailioaie LM; Department of Medical Physics, Alexandru Ioan Cuza University of Iasi, Iasi, Romania., Doležalová P; Department of Pediatrics and Inherited Metabolic Disorders, 1st Faculty of Medicine and General University Hospital, Charles University in Prague, Prague, Czech Republic., Cattalini M; Unita' di Immunologia e Reumatologia Pediatrica, Clinica Pediatrica dell'Universita' di Brescia, Spedali Civili, Brescia, Italy., Susic G; Division of Pediatric Rheumatology, Institute of Rheumatology of Belgrade, Belgrade, Serbia., Sztajnbok FR; Unit of Rheumatology, Adolescent Health Studies Center (NESA), Rio de Janeiro State University, Rio de Janeiro, Brazil., Maritsi D; 2nd Department of Pediatrics Athens Medical School, National and Kapodistrian University of Athens (NKUA), Athens, Greece., Constantin T; Unit of Pediatric Rheumatology-Immunology, Second Department of Pediatrics, Semmelweis University, Budapest, Hungary., Sawhney S; Sir Ganga Ram Hospital Marg, Centre for Child Health, Sir Ganga Ram Hospital, New Delhi, India., Rygg M; Department of Clinical and Molecular Medicine, Faculty of Medicine and Health Sciences, NTNU-Norwegian University of Science and Technology.; Department of Pediatrics, St Olavs University Hospital of Trondheim, Trondheim, Norway., Oliveira SK; Instituto de Puericultura e Pediatria Martagao Gesteira (IPPMG), Universidade Federal do Rio de Janeiro, Rio de Janeiro, Brazil., Nordal EB; Department of Pediatrics, University Hospital of North Norway.; Department of Clinical Medicine, UiT the Arctic University of Norway, Tromso, Norway., Saad-Magalhães C; Pediatric Rheumatology Unit, São Paulo State University (UNESP), Botucatu, Brasil., Rubio-Perez N; Departamento de Pediatria, Facultad de Medicina, Hospital Universitario 'Dr. J. E. González', Universidad Autónoma de Nuevo León, Monterrey, NL, Mexico., Jelusic M; Department of Paediatrics, University of Zagreb School of Medicine, Zagreb, Croatia., de Roock S; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands., Wulffraat NM; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands., Ruperto N; Clinica Pediatrica e Reumatologia, IRCCS Istituto Giannina Gaslini., Swart JF; Department of Pediatric Immunology and Rheumatology, Wilhelmina Children's Hospital, Utrecht, The Netherlands.
Jazyk:	angličtina
Zdroj:	Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2022 May 05; Vol. 61 (5), pp. 2104-2112.
DOI:	10.1093/rheumatology/keab678
Abstrakt:	Objective: To describe risk factors for IBD development in a cohort of children with 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 DMARDs were calculated, and differences between therapies were expressed as relative risks (RR). Results: Out of 8942 patients, 48 (0.54% ) 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 (39.6% vs 10.8%). The strongest predictors of IBD on multivariable analysis were enthesitis-related arthritis [odds ratio (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 enthesitis-related arthritis and a family history of autoimmune disease. An increased IBD incidence was observed for etanercept therapy regardless of concomitant methotrexate use. (© The Author(s) 2021. Published by Oxford University Press on behalf of the British Society for Rheumatology.)
Databáze:	MEDLINE
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