SynthesisRheumatology (Oxford, England)2016
Efficacy and safety of biological agents for systemic juvenile idiopathic arthritis: a systematic review and meta-analysis of randomized trials.
Synthesis in Rheumatology (Oxford, England), 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 33 papers, 4 of them syntheses that pooled it.
What it found
Each row is one number read from the abstract, on the scale the paper reported it, with its interval. Left of the dashed line favours the treatment, right favours the comparator. Under each row is the sentence it came from. New to these charts? A ten-minute tutorial.
The abstract states no effect estimate the extractor could read, or names no intervention and outcome on the map, so this paper lights no cell and moves no belief. It is still indexed, cited and linked below.
The trial behind it
Trials whose registry record cites this paper, or whose number appears in the abstract. A trial that started after this paper was published is citing it as background, not reporting it.
Neither the registry nor the abstract names a trial number. If this is a trial report, that itself is worth knowing.
Who cites it
33 citing papers in PubMed, 4 syntheses or guidelines pooled it, 75 citations in OpenAlex.
- Early intensification versus step-up biologic strategies in systemic juvenile idiopathic arthritis: a Bayesian network meta-analysis of remission and safety outcomes.Pediatric rheumatology online journal · 2026Pooled it
- Efficacy and safety of therapies for Still's disease and macrophage activation syndrome (MAS): a systematic review informing the EULAR/PReS guidelines for the management of Still's disease.Annals of the rheumatic diseases · 2024Pooled it
- Efficacy and safety of TNF inhibitors in the treatment of juvenile idiopathic arthritis: a systematic literature review.Pediatric rheumatology online journal · 2023Pooled it
- Value of Literature Review to Inform Development and Use of Biologics in Juvenile Idiopathic Arthritis.Frontiers in pediatrics · 2022Pooled it
- Canakinumab for Treatment of Adult-Onset Still's Disease to Achieve Reduction of Arthritic Manifestation (CONSIDER): phase II, randomised, double-blind, placebo-controlled, multicentre, investigator-initiated trial.Annals of the rheumatic diseases · 2020Trial
- IL-6 blockade in systemic juvenile idiopathic arthritis - achievement of inactive disease and remission (data from the German AID-registry).Pediatric rheumatology online journal · 2018Trial
- 25 Years of Biologics for the Treatment of Pediatric Rheumatic Disease: Advances in Prognosis and Ongoing Challenges.Arthritis care & research · 2025Review
- Comparative Effectiveness and Safety of the JAK Inhibitors and Biologic Disease-Modifying Antirheumatic Drugs in Treating Children With Nonsystemic Juvenile Idiopathic Arthritis: A Bayesian Meta-Analysis of Randomized Controlled Trials.ACR open rheumatology · 2025Article
- Clinical outcomes of tocilizumab therapy in polyarticular and systemic juvenile idiopathic arthritis: a single-center analysis (2018-2022).Rheumatology international · 2024Article
- Tocilizumab-induced hypofibrinogenemia in patients with systemic-onset juvenile idiopathic arthritis.Scientific reports · 2023Article
- Single nucleotide polymorphisms located in TNFA, IL1RN, IL6R, and IL6 genes are associated with COVID-19 risk and severity in an Iranian population.Cell biology international · 2022Article
- New intriguing possibility for prevention of coronavirus pneumonitis: Natural purified polyphenols.Oral diseases · 2022Article
- Understanding efficacy-safety balance of biologics in moderate-to-severe pediatric psoriasis.Frontiers in medicine · 2022Review
- Application of systems biology-based in silico tools to optimize treatment strategy identification in Still's disease.Arthritis research & therapy · 2021Article
- Experiences with IL-1 blockade in systemic juvenile idiopathic arthritis - data from the German AID-registry.Pediatric rheumatology online journal · 2021Article
- Biologics in juvenile idiopathic arthritis-main advantages and major challenges: A narrative review.Archives of rheumatology · 2021Review
- Neutrophil Homeostasis and Emergency Granulopoiesis: The Example of Systemic Juvenile Idiopathic Arthritis.Frontiers in immunology · 2021Review
- Anti-inflammatory Treatment of Kawasaki Disease: Comparison of Current Guidelines and Perspectives.Frontiers in medicine · 2021Review
- Inhibition of uric acid or IL-1β ameliorates respiratory syncytial virus immunopathology and development of asthma.Allergy · 2020Article
- Interleukin-1 Blockade in Systemic Juvenile Idiopathic Arthritis.Paediatric drugs · 2020Article
Corrections and comments
PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.
Authors and funding
8 authors at 4 institutions in 4 countries.
Funding
No grant is acknowledged in the PubMed record.
Abstract
objectiveTo define the optimal biologic agent for systemic JIA (sJIA) based on safety and efficacy data from a randomized controlled trial (RCT).
methodsThrough a systematic literature search, sJIA RCTs evaluating biologic agents were identified. The primary efficacy outcome was defined as a 30% improvement according to the modified American College of Rheumatology Paediatric 30 response criteria (JIA ACR30). The primary safety outcome was defined as serious adverse events (SAEs). Outcomes were analysed by pairwise and network meta-analyses. The quality of evidence between biologic agents was assessed by applying the Grading of Recommendations Assessment, Development, and Evaluation (GRADE) methodology.
resultsFrom the 493 citations originally identified, 5 RCTs were eligible for inclusion-one each for anakinra, canakinumab and tocilizumab and two for rilonacept: all vs placebo. While all were effective, the network meta-analysis indicated with low-quality evidence (due to indirect comparison and inconsistency) that rilonacept-treated patients were less likely to respond than those treated with canakinumab [odds ratio (OR) 0.10 (95% CI 0.02, 0.38), P = 0.001] or tocilizumab [OR 0.12 (95% CI 0.03, 0.44), P = 0.001]. Risks of SAEs were similar among the biologic agents (supported by very low-quality evidence) and not different from placebo.
conclusionDespite heterogeneous eligibility criteria and study designs across the five studies and different modified JIA ACR30 criteria, this meta-analysis of short-term RCTs presents empirical evidence that canakinumab and tocilizumab are more effective than rilonacept. Biologic agents in sJIA seem safe and comparable with respect to SAE risk in the short term.
Indexed as
Identifiers
What OpenQuestion holds
Registered trials
Read under generation 80e0d062 · epoch 390. Bibliography from PubMed, PubMed Central and OpenAlex; grants from NIH RePORTER; trial links from ClinicalTrials.gov; estimates, votes and beliefs from the OpenQuestion graph.