{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2025,12,2]],"date-time":"2025-12-02T22:37:58Z","timestamp":1764715078315,"version":"build-2065373602"},"reference-count":50,"publisher":"The Journal of Rheumatology","issue":"2","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":["J Rheumatol"],"published-print":{"date-parts":[[2023,2]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>To determine, among patients with axial spondyloarthritis (axSpA), whether the risk of inflammatory bowel disease (IBD) varies between patients treated with biologic therapies and those treated with other therapies and, specifically, whether the risk is higher in patients treated with etanercept (ETN).<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>The British Society for Rheumatology Biologics Register in Ankylosing Spondylitis (BSRBR-AS) was used to determine the incidence of IBD during follow-up and to calculate the incidence rate difference (IRD) per 1000 person-years (PY), between biologic treatment and other treatment groups. We then conducted a systematic review, involving observational studies and randomized controlled trials (RCTs), to perform a metaanalysis to quantify the difference in incidence of IBD between treatment groups.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>According to the BSRBR-AS, among people with axSpA, exposure to biologic therapy was associated with an increased incidence of IBD compared to those who were not exposed to biologic therapy (IRD 11.9, 95% CI 4.3-19.6). This finding was replicated across observational studies but was not seen in placebo-controlled RCTs (IRD 2.2, 95% CI \u22124.1 to 8.5). Data from the BSRBR-AS do not suggest that excess incidence of IBD is associated with exposure to ETN compared to other anti\u2013tumor necrosis factor (TNF) therapies (IRD \u22126.5, 95% CI \u221221.3 to 8.5). RCTs and their extensions suggest a small\u2014yet not statistically significant\u2014absolute increased incidence associated with ETN of between 2.1 and 5.8 per 1000 PY compared to other anti-TNF therapies.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>There was an excess risk of IBD among persons treated with biologics in observational studies. Only evidence from RCTs suggested that ETN was associated with an increased risk compared to other anti-TNF therapies, albeit with considerable uncertainty.<\/jats:p><\/jats:sec>","DOI":"10.3899\/jrheum.211034","type":"journal-article","created":{"date-parts":[[2022,7,1]],"date-time":"2022-07-01T12:20:58Z","timestamp":1656678058000},"page":"175-184","source":"Crossref","is-referenced-by-count":4,"title":["Inflammatory Bowel Disease Risk in Patients With Axial Spondyloarthritis Treated With Biologic Agents Determined Using the BSRBR-AS and a MetaAnalysis"],"prefix":"10.3899","volume":"50","author":[{"ORCID":"https:\/\/orcid.org\/0000-0003-2322-3314","authenticated-orcid":false,"given":"Gary J.","family":"Macfarlane","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-3434-5798","authenticated-orcid":false,"given":"Renke","family":"Biallas","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7667-5352","authenticated-orcid":false,"given":"Linda E.","family":"Dean","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Gareth T.","family":"Jones","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Nicola J.","family":"Goodson","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Ovidiu","family":"Rotariu","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"2262","published-online":{"date-parts":[[2022,7,1]]},"reference":[{"key":"2023020105301816000_50.2.175.1","doi-asserted-by":"publisher","DOI":"10.1136\/annrheumdis-2013-203582"},{"key":"2023020105301816000_50.2.175.2","doi-asserted-by":"crossref","first-page":"196","DOI":"10.1186\/s13075-016-1093-z","article-title":"Prevalence of peripheral and extra-articular disease in ankylosing spondylitis versus non-radiographic axial spondyloarthritis: a meta-analysis","volume":"18","author":"de Winter","year":"2016","journal-title":"Arthritis Res Ther"},{"key":"2023020105301816000_50.2.175.3","doi-asserted-by":"publisher","DOI":"10.1136\/rmdopen-2020-001206"},{"key":"2023020105301816000_50.2.175.4","doi-asserted-by":"crossref","first-page":"289","DOI":"10.1111\/apt.15370","article-title":"Increased risk of developing Crohn\u2019s disease or ulcerative colitis in 17 018 patients while under treatment with anti-TNF\u03b1 agents, particularly etanercept, for autoimmune diseases other than inflammatory bowel disease","volume":"50","author":"Korzenik","year":"2019","journal-title":"Aliment Pharmacol Ther"},{"key":"2023020105301816000_50.2.175.5","doi-asserted-by":"crossref","first-page":"347","DOI":"10.1186\/s12891-015-0805-x","article-title":"The British Society for Rheumatology Biologics Registers in Ankylosing Spondylitis (BSRBR-AS) study: protocol for a prospective cohort study of the long-term safety and quality of life outcomes of biologic treatment","volume":"16","author":"Macfarlane","year":"2015","journal-title":"BMC Musculoskelet Disord"},{"key":"2023020105301816000_50.2.175.6","first-page":"2286","article-title":"A new approach to defining disease status in ankylosing spondylitis: the Bath Ankylosing Spondylitis Disease Activity Index","volume":"21","author":"Garrett","year":"1994","journal-title":"J Rheumatol"},{"key":"2023020105301816000_50.2.175.7","unstructured":"Breslow NE , Day NE. 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