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.

中文翻译：

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无论是否同时使用甲氨蝶呤，依那西普在幼年特发性关节炎中的炎症性肠病发病率增加

目的 描述 JIA 儿童队列中 IBD 发展的危险因素。方法 从国际 Pharmachild 登记册中确定发生 IBD 的 JIA 患者。比较 IBD 和非 IBD 患者的特征，并使用多变量逻辑回归分析确定 IBD 的预测因子。计算了不同 DMARD 上 IBD 事件的发生率，治疗之间的差异表示为相对风险 (RR)。结果 在 8942 名患者中，48 名 (0.54%) 发生了 IBD。与未发生 IBD 的患者相比，这些患者更常见于男性（47.9% 对 32.0%）和 HLA-B27 阳性（38.2% 对 21.0%），并且在 JIA 发病时年龄更大（中位数 8.94 对 5.33 岁）。他们还经常有自身免疫性疾病（42.6% 对 24.4%）和肌腱端炎相关关节炎（39.6% 对 10.8%）的家族史。多变量分析中 IBD 的最强预测因子是肌腱端炎相关关节炎 [优势比 (OR): 3.68, 95% CI: 1.41, 9.40] 和自身免疫性疾病家族史 (OR: 2.27, 95% CI: 1.12, 4.54) . 与甲氨蝶呤单药治疗相比，依那西普单药治疗（RR：7.69、95% CI：1.99、29.74）、依那西普联合甲氨蝶呤（RR：5.70、95% CI：1.42、22.77）和英夫利昔单抗（RR：7.61、95）的IBD发生率% CI: 1.27, 45.57) 治疗明显更高。阿达木单抗的发生率没有显着差异（RR：1.45，95% CI：0.15，13.89）。结论 JIA的IBD与肌腱端炎相关性关节炎和自身免疫性疾病家族史有关。无论是否同时使用甲氨蝶呤，依那西普治疗均观察到 IBD 发病率增加。