Table 2 Immunological consequences of biologicals in juvenile idiopathic arthritis: incidence rates per 100 patient-years (weighted per study)

Normal childhood population

1.0 [17]

0.032 [53, 54, 56]

0.0069 new onset uveitis [77]

-

0.0083 IBD [78]

0.00015 optic neuritis [79]

0,0001 multiple sclerosis [80]

JIA without MTX, steroids or anti-TNF

2.2 [17]

0.025 [53, 56]

2.5 new onset uveitis^b [81, 82]

-

JIA with MTX

3.3 [17]

0.033 [56] to 0.046^c [54]

0.83 uveitis [83]

-

JIA with steroids

6.9 [17]

No data

No data

-

Abatacept

1.3 [57]

No data

0.22 uveitis flare (1 per 448 EY) [19]

23 (no adverse events) [57]

0.22 multiple sclerosis (1 per 448 EY) [19]

Adalimumab

2.9 [28–30]

No data

0 demyelinating diseases (0 per 348 EY) [28, 30]

7.6 with MTX within year; 15 after first year (no adverse events) [28, 30]

25.3 without MTX within first year; 60 after first year (no adverse events) [28, 30]

Anakinra

8.7 [20–22]

No data

No data

75.0 non-neutralizing antibodies within first year; 81.8 after first year [73]

6.3 neutralizing antibodies within first year; 0 after first year [73]

Etanercept

2.7 [17, 31–34]

0.015 [59]

0.44 new onset uveitis [32, 34] and 0.57 flares of uveitis [33, 35]

2.9 non-neutralizing antibodies [74]

0.31 newly diagnosed IBD [35, 70]

0.15 optic neuritis [31–35]

0.11 new onset lupus [31, 34, 35]

0.64 newly diagnosed sarcoidosis [32]

Infliximab

1.0 [36, 37]

No data

5.1 new onset uveitis [36]

36.6 positive and 32.4 inconclusive (infusion-reaction-related) [36]

25.9 new ANA (≥1:320) without symptoms [36]

6.6 new anti-double-stranded DNA antibodies without symptoms [36]

Rituximab

14.5^d [24]

No data

No data

No data

Tocilizumab

11.6^e [38–40]

No data

No data

7.1 (one anaphylactoid reaction without anti-IgE antibody) [38]