Spondyloarthritis & psoriatic arthritis
Association of Early-Life Exposures With Later Diagnosis of Spondyloarthritis: A Population-Based Case-Control Study
Main finding · SpA by first-year antibiotic exposureResult — go to the resultAdjusted odds ratio 1.35 95% CI 1.14–1.59Authors' conclusion
Antibiotic exposure in the first year of life, particularly broad-spectrum penicillins, was associated with increased odds of SpA by age 21
Study context
- Population
- Danish live births (1997–2023) reaching minimum relevant ages by December 31, 2024 (1–21 years for psoriatic arthritis (PsA); 6–21 years for peripheral/axial spondyloarthritis (SpA) and inflammatory bowel disease (IBD)-associated arthritis)560 cases
- Comparison
- First-year systemic antibiotic use vs no use, in SpA cases vs matched controls
- Casesn = 560
- Outcome
- SpA diagnosed by age 21; primary exposure systemic antibiotic use in the first year of life
- Follow-up
- By age 21
Methodological detailsmatched 1:50 by birth year, sex, and calendar year of diagnosis, conditional logistic regression, Wald test for dose response
- Matched 1:50 by birth year, sex, and calendar year of diagnosis
- Conditional logistic regression
- Wald test for dose response
Main finding
SpA by first-year antibiotic exposure · first year of life
Adjusted odds ratio
1.35
95% CI 1.14–1.59
By group
First-year antibioticsvs No first-year antibiotics
aOR 1.35 (95% CI 1.14–1.59)
As reported in the abstract
Observational data: associations, not effects.
Further findings
SpA by broad-spectrum penicillin exposure (strongest class-specific association) · first year of life
| aOR (95% CI) | ||
|---|---|---|
| Broad-spectrum penicillins | 1.42 (1.19–1.70) | |
| 0.512Adjusted odds ratio (log scale) |
SpA by early upper respiratory tract infection (URTI)
| aOR (95% CI) | ||
|---|---|---|
| Early URTIIndependently associated | 1.88 (1.32–2.67) | |
| 0.20.5125Adjusted odds ratio (log scale) |
| Outcome | aOR (95% CI) | |
|---|---|---|
| PsA by first-year antibiotics (subgroup) · first year of lifeFirst-year antibioticsvs No first-year antibioticsAssociation significant only for PsA among SpA subgroups | 1.75 (1.27–2.41) | |
| 0.512Adjusted odds ratio (log scale) |
SpA by delivery mode and systemic nonbacterial antimicrobials
- Not associated with SpA
Original publication
Association of Early-Life Exposures With Later Diagnosis of Spondyloarthritis: A Population-Based Case-Control Study. J Rheumatol. Published 15 August 2026. doi:10.
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