Development of inflammatory bowel disease in patients with juvenile idiopathic arthritis treated with etanercept

The Journal of Rheumatology, 04/06/2011

van Dijken TD et al. – The incidence of IBD in JIA patients using etanercept seems to be markedly increased, analyzing data from European registries. This incidence of IBD in the etanercept registries cannot be compared to the incidence of IBD in JIA patients using other treatment without etanercept, because such registries do not exist yet in all European countries. These findings are in keeping with a report of 8 new IBD cases occurring in French children with JIA using etanercept. These findings illustrate the need for large international disease-specific registries focused on outcome and pharmacovigilance.

Methods

  • National JIA registries for etanercept of The Netherlands, Germany, Finland, Denmark, and Italy searched for patients with JIA and IBD
  • Total number of patient-years used to calculate incidence
  • Physicians of identified patients asked to give clinical details

Results

  • 13 cases of IBD in JIA patients identified in registries between 1999 and 2008
  • IBD incidence in JIA patients while using etanercept was 362 per 100,000 patient-years under etanercept, about 43 times higher than in general pediatric population
  • Clinical presentation of IBD in JIA patients using etanercept was similar to that in non-JIA patients
  • Median time between onset of JIA and onset of IBD 6 years and 10 months
  • Time between start of etanercept and first appearance of IBD symptoms was between 9 days and 4.5 years

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