van Straalen JW, Krol RM, Giancane G, et al. - Inflammatory bowel disease (IBD) in juvenile idiopathic arthritis (JIA) was linked to enthesitis-related arthritis (ERA) and a family history of autoimmune disease. Regardless of concomitant methotrexate use, etanercept therapy was associated with an increase in IBD incidence.

• From the international Pharmachild register, JIA patients who developed IBD were identified. IBD affected 48 (0.05%) of the 8,942 patients.

• These patients were more likely to be male (47.9% vs 32.0%), HLA-B27 positive (38.2% vs 21.0%), and older at the time of JIA onset (median 8.94 vs 5.33 years) than patients without IBD development.

• They also showed a higher prevalence of autoimmune disease (42.6% vs 24.4%) and ERA (39.6% vs 10.8%).

• On multivariable analysis, the strongest predictors of IBD were ERA and a family history of autoimmune disease.

• The incidence of IBD on etanercept monotherapy, etanercept plus methotrexate, and infliximab therapy was considerably greater than on methotrexate monotherapy.

• The prevalence of adalimumab was not statistically different.