{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T13:14:02Z","timestamp":1788268442701,"version":"build-2803163510"},"reference-count":0,"publisher":"The Journal of Rheumatology","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"abstract":"<jats:sec>\n                    <jats:title>Objective<\/jats:title>\n                    <jats:p>To assess whether early-life antibiotics are associated with spondyloarthritis (SpA) diagnosed by age 21.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>In this population-based, matched case-control study, we used Danish live births (1997-2023) restricted to those reaching the following minimum relevant ages by December 31, 2024: 1-21 years for psoriatic arthritis (PsA), and 6-21 years for peripheral\/axial SpA and inflammatory bowel disease (IBD)-associated arthritis. Cases (n = 560) had physician-recorded SpA (peripheral\/axial SpA, PsA, or IBD-associated arthritis). Controls were matched 1:50 by birth year, sex, and calendar year of diagnosis. Primary exposure was systemic antibiotic use the first year of life; secondary exposures included antibiotic class, number of courses, delivery mode, early upper respiratory tract infection (URTI), and systemic nonbacterial antimicrobials. Conditional logistic regression estimated adjusted odds ratios (aORs); dose response was tested with the Wald test.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>Among cases (median age 16.8 years; 59% peripheral\/axial SpA, 28% PsA, 13% IBD-associated arthritis), 50% received antibiotics, vs 42% of controls. First-year antibiotic exposure was associated with higher odds of SpA (aOR 1.35, 95% CI 1.14-1.59). Broad-spectrum penicillins had the strongest class-specific association (aOR 1.42, 95% CI 1.19-1.70). Early URTI was independently associated with SpA (aOR 1.88, 95% CI 1.32-2.67); delivery mode and systemic nonbacterial antimicrobials were not. In SpA subgroup analysis, the association with first-year antibiotics was significant only for PsA (aOR 1.75, 95% CI 1.27-2.41).<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>Antibiotic exposure in the first year of life, particularly broad-spectrum penicillins, was associated with increased odds of SpA by age 21, supporting the hypothesis that early-life microbiome disruption may increase later SpA risk.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3899\/jrheum.2026-0087","type":"journal-article","created":{"date-parts":[[2026,8,15]],"date-time":"2026-08-15T12:20:19Z","timestamp":1786796419000},"page":"jrheum.2026-0087","source":"Crossref","is-referenced-by-count":0,"title":["Association of Early-Life Exposures With Later Diagnosis of Spondyloarthritis: A Population-Based Case-Control Study"],"prefix":"10.3899","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8233-8050","authenticated-orcid":false,"given":"Ana L.","family":"Altaffer","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-5568-388X","authenticated-orcid":false,"given":"Michael H.","family":"Weisman","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4837-5330","authenticated-orcid":false,"given":"Robert M.","family":"Kaplan","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-3594-2212","authenticated-orcid":false,"given":"Erzs\u00e9bet","family":"Horv\u00e1th-Puh\u00f3","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4299-7040","authenticated-orcid":false,"given":"Henrik Toft","family":"S\u00f8rensen","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-9724-0443","authenticated-orcid":false,"given":"Pamela F.","family":"Weiss","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"2262","published-online":{"date-parts":[[2026,8,15]]},"container-title":["The Journal of Rheumatology"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/syndication.highwire.org\/content\/doi\/10.3899\/jrheum.2026-0087","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2026,9,1]],"date-time":"2026-09-01T12:20:24Z","timestamp":1788265224000},"score":1,"resource":{"primary":{"URL":"http:\/\/www.jrheum.org\/lookup\/doi\/10.3899\/jrheum.2026-0087"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2026,8,15]]},"references-count":0,"alternative-id":["10.3899\/jrheum.2026-0087"],"URL":"https:\/\/doi.org\/10.3899\/jrheum.2026-0087","relation":{},"ISSN":["0315-162X","1499-2752","0315-162X"],"issn-type":[{"value":"0315-162X","type":"print"},{"value":"1499-2752","type":"electronic"},{"value":"0315-162X","type":"print"}],"subject":[],"published":{"date-parts":[[2026,8,15]]}}}