ArticleArthritis research & therapy2016
The risk of hospitalized infection following initiation of biologic agents versus methotrexate in the treatment of juvenile idiopathic arthritis.
Article in Arthritis research & therapy, 2016. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 21 papers, 2 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
21 citing papers in PubMed, 2 syntheses or guidelines pooled it, 46 citations in OpenAlex.
- 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis.Arthritis care & research · 2019Guideline
- 2019 American College of Rheumatology/Arthritis Foundation Guideline for the Treatment of Juvenile Idiopathic Arthritis: Therapeutic Approaches for Non-Systemic Polyarthritis, Sacroiliitis, and Enthesitis.Arthritis & rheumatology (Hoboken, N.J.) · 2019Guideline
- Recent antibiotic exposure and response to treatment of juvenile idiopathic arthritis: a retrospective cohort study.Arthritis research & therapy · 2026Article
- Literature analysis and implication of biologic therapy for children with non-systemic juvenile idiopathic arthritis in real-world settings.Intractable & rare diseases research · 2025Review
- Biological Agents' Adverse Events in Jordanian Childhood Rheumatic Diseases: A Single-Center Experience.Cureus · 2025Article
- How Safe Are Biological Agents in Pediatric Rheumatology?Turkish archives of pediatrics · 2024Article
- Hypersensitivity and Immune-related Adverse Events in Biologic Therapy.Clinical reviews in allergy & immunology · 2022Review
- Research progress in drug therapy of juvenile idiopathic arthritis.World journal of pediatrics : WJP · 2022Review
- Implications of Evolving Disease Classification for Drug Approval in Juvenile Idiopathic Arthritis.Paediatric drugs · 2022Article
- Making Decisions About Stopping Medicines for Well-Controlled Juvenile Idiopathic Arthritis: A Mixed-Methods Study of Patients and Caregivers.Arthritis care & research · 2021Article
- Long-term safety and effectiveness of etanercept in JIA: an 18-year experience from the BiKeR registry.Arthritis research & therapy · 2020Article
- COVID-19 and what pediatric rheumatologists should know: a review from a highly affected country.Pediatric rheumatology online journal · 2020Review
- Decreasing trend in the incidence of serious pneumonias in Finnish children with juvenile idiopathic arthritis.Clinical rheumatology · 2020Article
- Peripheral Blood Lymphocyte Analysis in Oligo- and Polyarticular Juvenile Idiopathic Arthritis Patients Receiving Methotrexate or Adalimumab Therapy: A Cross-Sectional Study.Frontiers in pediatrics · 2020Article
- Reduction in the utilization of prednisone or methotrexate in Canadian claims data following initiation of etanercept in pediatric patients with juvenile idiopathic arthritis.Pediatric rheumatology online journal · 2019Article
- [New drugs for treatment of juvenile idiopathic arthritis].Zeitschrift fur Rheumatologie · 2019Review
- [Biologics in the treatment of juvenile idiopathic arthritis : A comparison of mono- and combination therapy with synthetic DMARDs].Zeitschrift fur Rheumatologie · 2019Review
- Outcomes of non-infectious Paediatric uveitis in the era of biologic therapy.Pediatric rheumatology online journal · 2018Article
- High Levels of DEK Autoantibodies in Sera of Patients With Polyarticular Juvenile Idiopathic Arthritis and With Early Disease Flares Following Cessation of Anti-Tumor Necrosis Factor Therapy.Arthritis & rheumatology (Hoboken, N.J.) · 2018Article
- Anakinra in Still's disease: a profile of its use.Drugs & therapy perspectives : for rational drug selection and use · 2018Article
Corrections and comments
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Authors and funding
8 authors at 1 institution in 1 country.
Funding
Abstract
backgroundIn the present study, we compared the incidence of hospitalized infection among children with juvenile idiopathic arthritis (JIA) following initiation of treatment with biologic agents versus methotrexate (MTX).
methodsWe used national Medicaid claims data from 2000 through 2010 to create cohorts of children with JIA who were new users of tumor necrosis factor inhibitors (TNFi), anakinra, and MTX (without concurrent biologic agent use) as defined by a 6-month baseline period of nonuse. Because most anakinra users have systemic juvenile idiopathic arthritis (SJIA), we used claims to identify MTX users who likely had SJIA. Among TNFi users, concurrent MTX use was a time-varying covariate. The study outcome was a primary hospital discharge diagnosis of infection. We calculated adjusted hazard ratios (aHRs) to compare infection rates between biologic agents and MTX.
resultsWe identified 3075 new MTX users (160 with SJIA), 2713 new TNFi users, and 247 new anakinra users. There was no increased risk of infection associated with TNFi monotherapy versus MTX (aHR 1.19, 95 % CI 0.72-1.94) or with TNFi + MTX combination therapy versus MTX (aHR 1.23, 95 % CI 0.69-2.17). Baseline high-dose oral glucocorticoid use (≥10 mg/day of prednisone) was associated with infection (aHR 2.03 [95 % CI 1.21-3.39] versus no oral glucocorticoid). Anakinra was associated with infection versus MTX (aHR 3.53 95 % CI 1.83-6.82), but less so compared with MTX users with SJIA (aHR 2.69, 95 % CI 0.82-8.82).
conclusionsNeither TNFi monotherapy nor TNFi + MTX combination therapy was significantly associated with hospitalized infection compared with MTX. Anakinra was significantly associated with infection, but there was likely residual confounding by disease phenotype.
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.