Table 4.
Paradoxical IBD in Juvenile Idiopathic Arthritis.
| Study, Year | Number of Patients, Sex | JIA Onset | IBD Onset | Interval Onset JIA to IBD | Interval Onset Anti TNF to IBD | JIA Subtype | IBD | HLA-B27 | Treatment | Outcome |
|---|---|---|---|---|---|---|---|---|---|---|
| Gerloni et al., 2008 [51] | 5 n/a | n/a | n/a | n/a | n/a | n/a | 2 CD 1 ind IBD |
n/a | ETN | All switch to another anti-TNF |
| Dallochio et al., 2010 [49] | 6 F 2 M |
3–13 years | n/a | n/a | 7–78 months | 4 oligo JIA 1 RF poly JIA 1 systemic JIA 2 ERA |
5 CD 3 ind IBD |
n/a | 8 ETN | All ETN discontinued 6 IFX 2 AZA 3 + Mesalazine |
| Van Dijken et al., 2011 [50] | 10 F 3 M |
1–16 years | Median: 12 years | 5 years and 3 months | 9 days–4.5 years | 4 poly JIA 5 oligo-ext JIA 2 ERA 2 systemic JIA |
9 CD 3 UC 1 ind IBD |
All− | ETN | 8 switch to IFX 2 switch to ADA 3 Other (CS/SSZ/Mesalazine/Pentasa) ±other |
| Tarkiainen et al., 2011 [52] | F | 9.8 years | 15.2 years | 5.4 years | 2.1 years | Seronegative Poly | UC | + | ETN | ETN + Mesalazine + CS |
| M | 9.0 years | 12.6 years | 3.6 years | 2.8 years | ERA | CD | + | ETN | ETN + Mesalazine | |
| F | 4.3 years | 14.8 years | 10.5 years | 4.4 years | Ind arthritis | UC | + | ETN | ETN + SSZ + CS | |
| F | 3,7 years | 13.3 years | 9.6 years | 1.4 years | Seronegative poly | CD | − | IFX | AZA + CS + switch to ETN | |
| Toussirot et al., 2012 [3] | 1 M | 17 years | n/a | 6 years | n/a | ERA | CD | n/a | ETN | Switch to ADA |
| 1 M | 11 years | 1 year | ERA | Switch to IFX | ||||||
| Barthel et al., 2015 [48] | 3 M 8 F |
6.1 ± 3.9 years | 13.4 ± 3.4 years | 7.2 ± 4.0 years | 1.71 years | 3 oligo-ext 4 seroneg polyarthritis 2 ERA 2 psoriatic JIA |
8 CD 3 UC |
2 HLA B27+ 7 ANA+ |
9 ETN ± CS/NSAIDs/csDMARDs 2 Other (SSZ, MTX, LEF) |
ETN stopped Standard care (N/A) Switch: 4 ADA, 1 IFX |
| Van Straalen et al., 2022 [53] | 48 IBD (27 known onset) n/a |
n/a | 13.7 years | n/a | 382 days | n/a | 22 CD 13 UC 13 ind |
n/a | 13/27 ETN | n/a |
| Broekaert et al., 2023 [54] | 28 n/a | n/a | n/a | n/a | n/a | 25% ERA | 23 CD 4 UC 1 ind IBD |
20.3%+ | 23 ETN 5 other (NSAIDs, CS, MTX, SSL, LEF) |
n/a |
| Wiegering et al., 2010 [11] | 1 F | 7 years | 11 years | 4 years | 1 year | Oligo JIA (ANA+, RF−) | CD | - | ETN | SSZ—inefficient. then ADA |
| Flemming et al., 2013 [56] | 1 M | 12 years | 14 years | 2 years | 4 months | ERA (ANA, RF−) | CD | - | ETN | ETN stopped, switch to IFX |
| Ruemmele et al., 2004 [57] | 1 M | 2.5 years | 6 years | 3.5 years | n/a | Oligo JIA (ANA+, RF−) | CD flare | n/a | ETN | ETN stopped + 5-ASA then AZA then switch to IFX |
| Oikonomou et al., 2010 [58] | 1 F | 2 years | 17 years | 15 years | n/a | Oligo JIA | CD | n/a | ETN | ETN stopped Switch to IFX and then ADA |
| Actis et al., 2012 [59] | 1 M | 8 years | 13 years | 5 years | 28 months | Oligo-ext JIA | 1 UC | n/a | ETN | Switch to ADA then IFX Mesalamine—CS—AZA |
| Zeits et al., 2015 [60] | 1 M | 12 years | n/a | n/a | 2 months after ADA | n/a | CD | + | ETN then ADA | ADA Continued + CS then switch to IFX then right-sided colectomy with an ileocolic anastomosis then ETN—then stop ETN |
F = female, M = male, IBD = Inflammatory Bowel Disease, UC = ulcerative colitis, CD = Crohn’s disease, ind = indetermined, IFX = Infliximab, ETN = Etanercept, ADA = Adalimumab, poly = polyarticular JIA; oligo = oligoarticular JIA; oligo-ext = oligo-extended JIA; ERA = enthesitis-related arthritis, MTX = metotrexate, LEF = leflunomide, AZA = azathioprine, 5-ASA = 5-aminosalicylates, SSZ = sulfasalazine, CS = corticosteroids, NSAIDs = nonsteroidal anti-inflammatory drugs, ANA = antinuclear antibodies, RF = rheumatoid factor, n/a = not available.