Tumor necrosis factor inhibitor-related autoimmune disorders in pediatric rheumatology practice: a multicenter nationwide study
Authors' conclusion
Among TIRAIDs, non-infectious uveitis and PP were the most frequently observed manifestations, predominantly occurring during etanercept treatment. Disease activity tended to increase during the onset of TIRAIDs.
Study context
- Population
- Paediatric patients treated with a TNFi for a rheumatologic disease who developed TNFi-related autoimmune disorders (TNF inhibitor-related autoimmune disorders (TIRAIDs)), over a 10-year periodfrom 2450 TNFi-treated patients
- Participants
- 71 patients
- Outcome
- Prevalence of TIRAIDs among paediatric patients using any TNFi
Methodological detailsnationwide
- Nationwide
Main finding
As reported in the abstract
Prevalence of TIRAIDs
Prevalence of TIRAIDs among 2450 TNFi-treated paediatric patients
2.8%
Observational data: associations, not effects.
Further findings
| Outcome | P value |
|---|---|
| CRP and JADAS-27 during TIRAID onset vs remission, JIA (subgroup)TIRAID development vs Remission period | P < 0.001 |
| CRP and JADAS-27 during TIRAID onset vs remission, JIA (subgroup)TIRAID development vs Remission period | P = 0.041 |
Female sex
- Female predominance (n = 40)
- 56%
TIRAIDs by TNFi drug
- Etanercept (n = 49)
- 69%
- Adalimumab (n = 16)
- 23%
- Infliximab (n = 6)
- 8%
Time to TIRAIDs
- Median time to TIRAIDs (months)
- 21.6
Type of TIRAID
- Non-infectious uveitis (most common)
- 38%
- Paradoxical psoriasis
- 25%
- Lupus-like disease
- 8%
- Multiple sclerosis
- 7%
- Episcleritis
- 7%
- Hidradenitis suppurativa
- 1%
Management
- Switched to another TNFi
- 58%
- Switched to non-TNF biologic and/or cDMARDs
- 42%
- Complete resolution of TIRAIDs
- 63%
Original publication
Tumor necrosis factor inhibitor-related autoimmune disorders in pediatric rheumatology practice: a multicenter nationwide study. Pediatr Rheumatol Online J. Published 19 June 2026. doi:10.
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