{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T04:25:05Z","timestamp":1783398305773,"version":"3.54.6"},"reference-count":16,"publisher":"The Journal of Rheumatology","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"accepted":{"date-parts":[[2017,7,6]]},"published-print":{"date-parts":[[2018,1]]},"abstract":"<jats:sec><jats:title>Objective.<\/jats:title><jats:p>To characterize the effect of anti-tumor necrosis factor (TNF) therapy compared to conventional synthetic disease-modifying antirheumatic drugs (csDMARD) in children with enthesitis-related arthritis (ERA) over the first year after diagnosis.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods.<\/jats:title><jats:p>We conducted a multicenter retrospective comparative effectiveness study of children diagnosed with ERA. We estimated the effect of anti-TNF therapy on clinical variables (active joint count, tender entheses count) and patient-reported pain and global assessment of disease activity over the first year after diagnosis using state-of-the-art comparative effectiveness analytic methods.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results.<\/jats:title><jats:p>During the study period, 217 patients newly diagnosed with ERA had a total of 965 clinic visits the first year after disease diagnosis. Children [median age 11.6 yrs, interquartile range 10\u201314] were treated with anti-TNF monotherapy (n = 33, 15.2%), csDMARD monotherapy (n = 73, 33.6%), or both (n = 52, 23.9%) in the first year after disease diagnosis. There was a statistically significant improvement in the primary outcome, active joint count, over time in children who received an anti-TNF drug versus those who did not (p = 0.03). Additionally, use of anti-TNF therapy versus no anti-TNF therapy was associated with less patient-reported pain (p &lt; 0.01) and improved disease activity over time as assessed by the clinical Juvenile Arthritis Disease Activity Score (p &lt; 0.01). The magnitude of estimated effect on clinical outcomes was uniformly greater, with the exception of tender entheses count, in children treated with an anti-TNF drug versus a csDMARD.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion.<\/jats:title><jats:p>During the first year after diagnosis, anti-TNF exposure was associated with benefits for several clinically meaningful outcomes in children with enthesitis-related arthritis.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.170251","type":"journal-article","created":{"date-parts":[[2017,9,16]],"date-time":"2017-09-16T00:20:13Z","timestamp":1505521213000},"page":"107-114","source":"Crossref","is-referenced-by-count":14,"title":["Comparative Effectiveness of Tumor Necrosis Factor Agents and Disease-modifying Antirheumatic Therapy in Children with Enthesitis-related Arthritis: The First Year after Diagnosis"],"prefix":"10.3899","volume":"45","author":[{"given":"Pamela F.","family":"Weiss","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rui","family":"Xiao","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy G.","family":"Brandon","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ilaria","family":"Pagnini","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tracey B.","family":"Wright","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Timothy","family":"Beukelman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Esi","family":"Morgan-DeWitt","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Chris","family":"Feudtner","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2017,9,15]]},"reference":[{"key":"2025062500201577000_45.1.107.1","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22657"},{"key":"2025062500201577000_45.1.107.2","doi-asserted-by":"publisher","DOI":"10.1002\/art.39145"},{"key":"2025062500201577000_45.1.107.3","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2012-203046"},{"key":"2025062500201577000_45.1.107.4","doi-asserted-by":"publisher","DOI":"10.1002\/acr.20460"},{"key":"2025062500201577000_45.1.107.5","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110427"},{"key":"2025062500201577000_45.1.107.6","doi-asserted-by":"publisher","DOI":"10.3899\/jrheum.110145"},{"key":"2025062500201577000_45.1.107.7","first-page":"390","article-title":"International League of Associations for Rheumatology classification of juvenile idiopathic arthritis: second revision, Edmonton, 2001","volume":"31","author":"Petty","year":"2004","journal-title":"J Rheumatol"},{"key":"2025062500201577000_45.1.107.8","first-page":"234","article-title":"Juvenile idiopathic arthritis classification criteria: loopholes and diagnosis software","volume":"34","author":"Behrens","year":"2007","journal-title":"J Rheumatol"},{"key":"2025062500201577000_45.1.107.9","doi-asserted-by":"publisher","DOI":"10.1186\/s13075-017-1297-x"},{"key":"2025062500201577000_45.1.107.10","doi-asserted-by":"publisher","DOI":"10.1002\/acr.22411"},{"key":"2025062500201577000_45.1.107.11","doi-asserted-by":"crossref","first-page":"6","DOI":"10.1136\/annrheumdis-2012-202031","article-title":"Validity of a three-variable Juvenile Arthritis Disease Activity Score in children with new-onset juvenile idiopathic arthritis","volume":"72","author":"McErlane","year":"2013","journal-title":"Ann Rheum Dis"},{"key":"2025062500201577000_45.1.107.12","doi-asserted-by":"publisher","DOI":"10.1097\/00001648-200009000-00011"},{"key":"2025062500201577000_45.1.107.13","first-page":"335","article-title":"Confounding by indication","volume":"7","author":"Walker","year":"1996","journal-title":"Epidemiology"},{"key":"2025062500201577000_45.1.107.14","doi-asserted-by":"crossref","unstructured":"Csizmadi I Collet JP Boivin JF . 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