Evidence map›Paper›PMID 37094979›Full record

ArticleRMD open2023

Methotrexate therapy associated with a reduced rate of new-onset uveitis in patients with biological-naïve juvenile idiopathic arthritis.

Joeri W van Straalen, Görkem Akay, Carlyn V Kouwenberg, Sytze de Roock, Viera Kalinina Ayuso, Nico M Wulffraat, Joke de Boer, Joost F Swart

Erratum issuedOpen access · goldAbstract read
In one paragraph

Article in RMD open, 2023. The graph could read no effect estimate from its abstract, so it casts no vote on the map. An erratum has been issued. Cited by 3 papers, 1 of them a synthesis that pooled it.

0numbers the graph read from it
0cells of the map it votes in
3citing papers in PubMed, 1 pooled it
2.6field-weighted citation impact, top 10% 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

3 citing papers in PubMed, 1 synthesis or guideline pooled it, 9 citations in OpenAlex.

  1. Guideline
  2. Article
  3. Article
4 · The record

Corrections and comments

5 · Who and what money

Authors and funding

8 authors at 1 institution in 1 country.

Joeri W van StraalenWilhelmina Children's Hospital, Department of Paediatric Immunology and Rheumatology, University Medical Centre Utrecht, Utrecht, Netherlands j.w.vanstraalen-2@umcutrecht.nl.ORCID 0000-0002-8766-6694
Görkem AkayWilhelmina Children's Hospital, Department of Paediatric Immunology and Rheumatology, University Medical Centre Utrecht, Utrecht, Netherlands.
Carlyn V KouwenbergFaculty of Medicine, Utrecht University, Utrecht, Netherlands.
Sytze de RoockWilhelmina Children's Hospital, Department of Paediatric Immunology and Rheumatology, University Medical Centre Utrecht, Utrecht, Netherlands.
Viera Kalinina AyusoFaculty of Medicine, Utrecht University, Utrecht, Netherlands.
Nico M WulffraatWilhelmina Children's Hospital, Department of Paediatric Immunology and Rheumatology, University Medical Centre Utrecht, Utrecht, Netherlands.
Joke de BoerFaculty of Medicine, Utrecht University, Utrecht, Netherlands.
Joost F SwartWilhelmina Children's Hospital, Department of Paediatric Immunology and Rheumatology, University Medical Centre Utrecht, Utrecht, Netherlands.ORCID 0000-0002-2759-2822
Utrecht University · NL

Funding

No grant is acknowledged in the PubMed record.

6 · The paper itself

Abstract

objectiveTo study the effect of methotrexate (MTX) therapy on new-onset uveitis in patients with biological-naïve juvenile idiopathic arthritis (JIA).

methodsIn this matched case-control study, we compared MTX exposure between cases with JIA-associated chronic uveitis (JIA-U) and patients with JIA and without JIA-U at the time of matching (controls). Data were collected from electronic health records of the University Medical Centre Utrecht, the Netherlands. Cases with JIA-U were matched 1:1 to JIA control patients based on JIA diagnosis date, age at JIA diagnosis, JIA subtype, antinuclear antibodies status and disease duration. The effect of MTX on JIA-U onset was analysed using a multivariable time-varying Cox regression analysis.

resultsNinety-two patients with JIA were included and characteristics were similar between cases with JIA-U (n=46) and controls (n=46). Both ever-use of MTX and exposure years were lower in cases with JIA-U than in controls. Cases with JIA-U significantly more often discontinued MTX treatment (p=0.03) and out of those who did, 50% afterwards developed uveitis within 1 year. On adjusted analysis, MTX was associated with a significantly reduced new-onset uveitis rate (HR: 0.35; 95% CI: 0.17 to 0.75). No different effect was observed between a low (<10 mg/m

conclusionThis study demonstrates an independent protective effect of MTX on new-onset uveitis in patients with biological-naïve JIA. Clinicians might consider early initiation of MTX in patients at high uveitis risk. We advocate more frequent ophthalmologic screening in the first 6-12 months after MTX discontinuation.

Indexed as

Antirheumatic AgentsArthritis, JuvenileUveitisCase-Control StudiesHumansMethotrexateAntirheumatic AgentsMethotrexateArthritis, JuvenileAutoimmune DiseasesEpidemiologyMethotrexate

Identifiers

PMID37094979
PMCPMC10151999
OpenAlexW4366817564

What OpenQuestion holds

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LicenceCC BY-NC
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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.