{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,1,13]],"date-time":"2026-01-13T15:26:06Z","timestamp":1768317966641,"version":"3.49.0"},"reference-count":46,"publisher":"Oxford University Press (OUP)","issue":"1","license":[{"start":{"date-parts":[[2024,5,25]],"date-time":"2024-05-25T00:00:00Z","timestamp":1716595200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/academic.oup.com\/journals\/pages\/open_access\/funder_policies\/chorus\/standard_publication_model"}],"content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2024,12,25]]},"abstract":"<jats:title>ABSTRACT<\/jats:title>\n               <jats:sec>\n                  <jats:title>Objectives<\/jats:title>\n                  <jats:p>This systematic review assessed the efficacy and safety of tumor necrosis factor (TNF) inhibitors in patients with systemic juvenile idiopathic arthritis (JIA).<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Methods<\/jats:title>\n                  <jats:p>Studies were searched using PubMed, Embase, Cochrane, Ichushi-Web, and clinical trial registries (from 2000 to 2021). The risk of bias was assessed using the Cochrane Risk of Bias version 2 for randomized controlled trials (RCTs) and the manual of Minds for observational studies.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Results<\/jats:title>\n                  <jats:p>One RCT and 22 observational studies were included. In the RCT on infliximab, the American College of Rheumatology pediatric (ACR Pedi) 30\/50\/70 responses at 14\u2009weeks were 63.8%\/50.0%\/22.4%, with relative risks of 1.30 [95% confidence interval (CI): 0.94\u20131.79]\/1.48 (95% CI: 0.95\u20132.29)\/1.89 (95% CI: 0.81\u20134.40), respectively. In the observational studies, ACR Pedi 30\/50\/70 responses for etanercept at 12\u2009months were 76.7%\/64.7%\/46.4%, respectively. Infliximab treatment caused anaphylaxis in 17% and an infusion reaction in 23% of patients. The incidence of macrophage activation syndrome, serious infection, and malignancy caused by TNF inhibitors was 0\u20134%.<\/jats:p>\n               <\/jats:sec>\n               <jats:sec>\n                  <jats:title>Conclusions<\/jats:title>\n                  <jats:p>Thus, although TNF inhibitors were relatively safe, they were unlikely to be preferentially administered in patients with systemic JIA because of their inadequate efficacy. Further studies, especially well-designed RCTs, are needed to accumulate clinical data.<\/jats:p>\n               <\/jats:sec>","DOI":"10.1093\/mr\/roae050","type":"journal-article","created":{"date-parts":[[2024,5,24]],"date-time":"2024-05-24T17:13:47Z","timestamp":1716570827000},"page":"174-184","source":"Crossref","is-referenced-by-count":3,"title":["Efficacy and safety of tumor necrosis factor inhibitors for systemic juvenile idiopathic arthritis: A systematic review"],"prefix":"10.1093","volume":"35","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-0247-7729","authenticated-orcid":false,"given":"Takashi","family":"Ishikawa","sequence":"first","affiliation":[{"name":"Division of Immunology, National Center for Child Health and Development , Tokyo,","place":["Japan"]},{"name":"Department of Pediatrics, Jikei University School of Medicine , 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Rheumatology, Department of Internal Medicine, Keio University School of Medicine , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroshi","family":"Takase","sequence":"additional","affiliation":[{"name":"Department of Ophthalmology & Visual Science, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , Tokyo,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Hiroaki","family":"Umebayashi","sequence":"additional","affiliation":[{"name":"Department of Rheumatism, Infectious Disease, Miyagi Children\u2019s Hospital , Miyagi,","place":["Japan"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Natsuka","family":"Umezawa","sequence":"additional","affiliation":[{"name":"Department of Rheumatology, Graduate School of Medical and Dental Sciences, Tokyo Medical and Dental University , 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