Evidence map›Paper›PMID 31605484›Full record

ArticleRheumatology (Oxford, England)2020

The risk of uveitis in patients with JIA receiving etanercept: the challenges of analysing real-world data.

Rebecca Davies, Diederik De Cock, Lianne Kearsley-Fleet, Taunton Southwood, Eileen Baildam, Michael W Beresford, Helen E Foster, Wendy Thomson, Athimalaipet V Ramanan, Kimme L Hyrich and 1 more

Open access · hybridAbstract readComparative Study
In one paragraph

Article in Rheumatology (Oxford, England), 2020. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Cited by 6 papers.

0numbers the graph read from it
0cells of the map it votes in
6citing papers in PubMed
1.5field-weighted citation impact, top 19% of its field
1 · What the graph read from 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.

2 · The registry

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.

3 · Its place in the literature

Who cites it

6 citing papers in PubMed, 17 citations in OpenAlex.

  1. Review
  2. Review
  3. Review
  4. Article
  5. Uveitis in Children and Adolescents.Rheumatic diseases clinics of North America · 2021
    Review
  6. Article
4 · The record

Corrections and comments

PubMed lists nothing against this paper. Absence here is not a guarantee, only a check that was made.

5 · Who and what money

Authors and funding

11 authors at 6 institutions in 1 country.

Rebecca DaviesArthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester.
Diederik De CockArthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester.
Lianne Kearsley-FleetArthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester.
Taunton SouthwoodInstitute of Child Health, University of Birmingham & Birmingham Children's Hospital, Birmingham.
Eileen BaildamClinical Academic Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool.
Michael W BeresfordClinical Academic Department of Paediatric Rheumatology, Alder Hey Children's NHS Foundation Trust, Liverpool.
Helen E FosterMusculoskeletal Research Group, Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne.
Wendy ThomsonArthritis Research UK Centre for Genetics and Genomics, Centre for Musculoskeletal Research, Faculty of Biologic, Medicine and Health, The University of Manchester, Manchester.
Athimalaipet V RamananBristol Medical School, University of Bristol, Bristol.
Kimme L HyrichArthritis Research UK Centre for Epidemiology, Centre for Musculoskeletal Research, The University of Manchester, Manchester Academic Health Science Centre, Manchester.
British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study (BSPAR-ETN) and the Biologics for Children with Rheumatic Diseases (BCRD) study
Manchester Academic Health Science Centre · GBAlder Hey Children's NHS Foundation Trust · GBBirmingham Children's Hospital · GBGreat North Children's Hospital · GBUniversity Hospitals Bristol NHS Foundation Trust · GBUniversity of Liverpool · GB

Funding

Medical Research Council MR/R013926/1Versus Arthritis 20747
6 · The paper itself

Abstract

objectivesTo describe and compare the occurrence of newly diagnosed uveitis in children with JIA receiving MTX, etanercept, adalimumab and infliximab.

methodsThis on-drug analysis included patients within UK JIA registries (British Society for Paediatric and Adolescent Rheumatology Etanercept Cohort Study and Biologics for Children with Rheumatic Diseases) with non-systemic disease, registered at MTX or biologic start with no history of uveitis. Follow-up began from date of first treatment, continuing until first uveitis, discontinuation of registered drug, most recent follow-up up or death, whichever came first. Hazard ratios comparing risk of uveitis between drugs were calculated using propensity-adjusted Cox regression.

resultsA total of 2294 patients were included (943 MTX, 304 adalimumab/infliximab, 1047 etanercept). There were 44 reported cases of uveitis (27 MTX, 16 etanercept, 1 adalimumab). Unadjusted hazard ratio showed a reduced risk of uveitis in biologic cohorts compared with MTX. After adjusting for propensity deciles, there was no significant difference in the risk of uveitis between patients receiving etanercept or MTX [hazard ratio 0.5 (0.2-1.1)]. Fully adjusted comparisons were not possible for adalimumab/infliximab as there were too few events.

conclusionsIn this first paper to compare the rate of new onset uveitis across the three main anti-TNF therapies used in JIA, a new diagnosis of uveitis is less common among patients starting biologics compared with MTX, although this did not reach statistical significance. The suggested protective effect of etanercept is likely explained by confounding, whereby patients in the MTX cohort are younger and earlier in disease, and therefore at greater risk of developing uveitis compared with etanercept patients.

Indexed as

AdalimumabAdolescentAntirheumatic AgentsArthritis, JuvenileBiological ProductsChildChild, PreschoolCohort StudiesEtanerceptFemaleHumansInfliximabMaleMethotrexateProportional Hazards ModelsRegistriesAdalimumabAntirheumatic AgentsBiological ProductsEtanerceptInfliximabMethotrexateTumor Necrosis Factor Inhibitorsbiasbiologic therapyJIAuveitis

Identifiers

PMID31605484
PMCPMC7244776
OpenAlexW2970115533

What OpenQuestion holds

Textmetadata
LicenceCC BY
Read underepoch 390

Registered trials

None linked

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.