Fecal Calprotectin to Detect Inflammatory Bowel Disease in Juvenile Idiopathic Arthritis

Ferrara, Giovanna; Pastore, Serena; Sancin, Lara; Torelli, Lucio; Radillo, Oriano; Bramuzzo, Matteo; Bibalo, Chiara; Tommasini, Alberto; Ventura, Alessandro; Taddio, Andrea

doi:10.3899/jrheum.171200

Cited by 4 publications

(3 citation statements)

References 18 publications

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“…Following our prediction model, the highest predicted probability of IBD in our cohort was 4.6%. Although this risk may not seem high, the implications are huge and screening for underlying IBD is quite simple, cheap and harmless by performing a faecal calprotectin test [22,23]. Therefore, this screening might be appropriate in relatively high-risk patients who according to our analysis would be male ERA patients with older age at JIA onset and a family history of autoimmune disease.…”

Section: Discussionmentioning

confidence: 99%

Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use

et al. 2021

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Objectives To describe risk factors for inflammatory bowel disease (IBD) development in a cohort of children with juvenile idiopathic arthritis (JIA). Methods JIA patients who developed IBD were identified from the international Pharmachild register. Characteristics were compared between IBD and non-IBD patients and predictors of IBD were determined using multivariable logistic regression analysis. Incidence rates of IBD events on different disease-modifying anti-rheumatic drugs (DMARDs) were calculated, differences between therapies were expressed as relative risks (RR). Results Out of 8,942 patients, 48 (0.05%) developed IBD. These were more often male (47.9% vs 32.0%) and HLA-B27 positive (38.2% vs 21.0%) and older at JIA onset (median 8.94 vs 5.33 years) than patients without IBD development. They also had more often a family history of autoimmune disease (42.6% vs 24.4%) and enthesitis-related arthritis (ERA) (39.6% vs 10.8%). The strongest predictors of IBD on multivariable analysis were ERA (OR: 3.68, 95% CI: 1.41–9.40) and a family history of autoimmune disease (OR: 2.27, 95% CI: 1.12–4.54). Compared with methotrexate monotherapy, the incidence of IBD on etanercept monotherapy (RR: 7.69, 95% CI: 1.99–29.74), etanercept with methotrexate (RR: 5.70, 95% CI: 1.42–22.77) and infliximab (RR: 7.61, 95% CI: 1.27–45.57) therapy was significantly higher. Incidence on adalimumab was not significantly different (RR: 1.45, 95% CI: 0.15–13.89). Conclusion IBD in JIA was associated with ERA and a family history of autoimmune disease. An increased IBD incidence was observed for etanercept therapy regardless of concomitant methotrexate use.

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Section: Discussionmentioning

confidence: 99%

Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use

et al. 2021

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“…A thorough gastrointestinal history and physical exam should be performed before the initiation of Secukinumab or any other IL-17 blocker. Fecal calprotectin is also a screening test that could be considered to identify IBD in patients with JIA [ 15 ].…”

Section: Discussionmentioning

confidence: 99%

Secukinumab-Induced Crohn's Disease in a Patient Treated for Juvenile Idiopathic Arthritis

Edupuganti,

Khine,

Gupta

et al. 2023

Cureus

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Juvenile idiopathic arthritis (JIA) is a common form of arthritis that occurs in children, typically with an onset before the age of 16 years. It can affect joints in any part of the body. As per the International League of Rheumatology, JIA is classified into systemic arthritis, oligoarthritis, extended oligoarthritis, polyarthritis (rheumatoid factor positive), polyarthritis (rheumatoid factor negative), enthesitis-related arthritis (ERA), juvenile psoriatic arthritis (JPsA), and other arthritis . JIA is treated with disease-modifying antirheumatic medications (DMARDs), which include both nonbiologic agents like methotrexate (MTX) and biologic agents like inhibitors of tumor necrosis factor-alpha, interleukin-1 (IL-1), IL-6, and T-cell co-stimulation modulators. As per recent studies, in December 2021, Secukinumab, an IL-17A inhibitor, is one of the most recent biologic agents approved for active ERA and JPsA. A few reports have suggested Secukinumab is related to new-onset inflammatory bowel diseases (IBDs). We present a case of a 20-year-old female who was being treated with Secukinumab for JIA, and six months into therapy, she developed symptoms suggestive of Crohn’s disease (CD). The diagnosis was confirmed with colonoscopy, histopathology, and radiology results. Her symptoms completely resolved four weeks after discontinuing Secukinumab and oral steroid therapy. The efficacy and side effects of Secukinumab have been studied mainly on middle-aged populations who were being treated for psoriasis and ankylosing spondylitis (AS); however, there is limited literature on younger populations. With this case report, we would like to highlight the possible relationship between the development of IBD and Secukinumab therapy in the adolescent population and emphasize the importance of regular screening for IBD in this population.

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“…It is unrelated to IBD activity and hence may precede the IBD diagnosis by years. Therefore, all patients with SpA need to be screened for associated subclinical gut inflammation through fecal calprotectin [43][44][45].…”

Section: Rheumatic Conditionsmentioning

confidence: 99%

Acute Arthritis in Children: How to Discern between Septic and Non-Septic Arthritis?

et al. 2021

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The term septic arthritis refers to an infection of the synovial space. This is an infrequent condition in healthy children, but it should be considered a medical emergency potentially leading to irreversible articular damage. Therefore, prompt diagnosis and antimicrobial treatment play a crucial role in improving the prognosis. Although septic arthritis is the most common cause of acute arthritis, many other diseases may mimic a similar clinical picture, constituting a diagnostic challenge for the clinician who first approaches the patient. Herein we analyze the main features of septic arthritis, offering an overview of the main conditions involved in the differential diagnosis and suggesting a diagnostic workup plan.

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Fecal Calprotectin to Detect Inflammatory Bowel Disease in Juvenile Idiopathic Arthritis

Abstract: FC is a useful, economical, and noninvasive diagnostic tool to identify JIA patients with underlying IBD.

Cited by 4 publications

References 18 publications

Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use

Increased incidence of inflammatory bowel disease on etanercept in juvenile idiopathic arthritis regardless of concomitant methotrexate use

Secukinumab-Induced Crohn's Disease in a Patient Treated for Juvenile Idiopathic Arthritis

Acute Arthritis in Children: How to Discern between Septic and Non-Septic Arthritis?

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