Study Identifies Predictors of IBD in Juvenile Idiopathic Arthritis

The strongest predictors of inflammatory bowel disease (IBD) in a cohort of patients with juvenile idiopathic arthritis (JIA) were enthesitis-related arthritis and a family history of autoimmune disease, according to study results published online ahead of print in Rheumatology.

“The incidence of inflammatory bowel disease on therapy with both etanercept and methotrexate, etanercept monotherapy, and infliximab was significantly higher compared with methotrexate monotherapy,” researchers added.

The results stemmed from an analysis of 8942 patients with JIA. Among them, 48 patients developed IBD.

A comparison of patients showed that those who developed IBD were more often male, HLA-B27 positive, and older at onset of JIA; the median age of onset was about 9 years. Compared with patients who did not develop IBD, those who did more often had a family history of autoimmune disease (42.6%) and enthesitis-related arthritis (39.6%).

Compared with methotrexate monotherapy, the relative risks for IBD were 7.69 with etanercept monotherapy, 5.70 with etanercept and methotrexate, and 7.61 with infliximab. The relative risk for IBD with adalimumab, however, was just 1.45.

“Hence, it might be suggested to consider adalimumab as the biologic of choice for treatment of enthesitis-related arthritis patients with a family history of autoimmune disease,” researchers advised.

—Jolynn Tumolo

Reference

van Straalen JW, Krol RM, Giancane G, et al. Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use. Rheumatology. Published online ahead of print, September 11, 2021.