ArticleThe Journal of rheumatology2026
Clinical Disease Manifestations Associated With Tumor Necrosis Factor Inhibitor Nonresponse in Juvenile Spondyloarthritis.
Article in The Journal of rheumatology, 2026. The graph could read no effect estimate from its abstract, so it casts no vote on the map. Not yet cited in PubMed.
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Abstract
objectiveTo identify the clinical characteristics associated with initial tumor necrosis factor inhibitor (TNFi) nonresponse in patients with juvenile spondyloarthritis (JSpA).
methodsThis is a retrospective analysis of patients with JSpA enrolled in the Childhood Arthritis and Rheumatology Research Alliance (CARRA) Registry between July 2015 and January 2019 and their response to their first TNFi agent. The JSpA population included those with enthesitis-related arthritis, psoriatic arthritis, and undifferentiated arthritis. Demographic and disease characteristics were compared at baseline visits prior to TNFi start and at the time of initial TNFi nonresponse or the visit closest to 6 months following TNFi start for the responders.
resultsInclusion criteria were met by 286 patients; 168 were TNFi responders and 118 were TNFi nonresponders. Median time to TNFi nonresponse was 8.9 (IQR 5.3-14.2) months. Median age at TNFi start was similar for nonresponders (13.9 years) and responders (13.8 years;
conclusionMost nonresponders to TNFi had secondary nonresponse. Patients with JSpA who did not respond to initial TNFi were more likely to be female and have longer symptom duration prior to starting a TNFi, clinical sacroiliitis, and a higher BMI and higher PtGA scores at baseline. Patients with these features should be monitored more carefully for treatment response.
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