OBJECTIVES: To describe the efficacy and safety of different biological agents in a large cohort of 20 patients with adult-onset Still's disease (AOSD). METHOD: We retrospectively evaluated 20 patients with severe or refractory AOSD treated with at least one biological agent (anakinra, etanercept, tocilizumab, and adalimumab), followed up for at least 12 months at our Institution. We collected and analysed data on the disease course, treatment outcome, and adverse effects, and compared our data with other published series. RESULTS: The median duration of follow-up was 5 years. In 12 patients a single biological drug induced a clinical response. In eight patients the biological agent that was first administered proved ineffective, and a switch to a different biologic was necessary. In three patients a third biologic was necessary to achieve disease control. The biologics eventually determined a clinical response in all patients. Patients with systemic disease showed better responses than patients with chronic articular disease (p < 0.05). Biological agents allowed either the withdrawal or the tapering of corticosteroid therapy (p < 0.0001) and of disease-modifying anti-rheumatic agents (DMARDs; p < 0.05). Three patients experienced herpes zoster reactivation. CONCLUSIONS: This is the longest follow-up of a cohort of AOSD patients treated with biological agents. Our data show that biologics are safe and generally effective in the long-term management of AOSD, particularly in cases with systemic disease, and suggest that a clinical response can be obtained in almost all AOSD patients, although a switch to drugs with a different mechanism of action may be necessary.
OBJECTIVES: To describe the efficacy and safety of different biological agents in a large cohort of 20 patients with adult-onset Still's disease (AOSD). METHOD: We retrospectively evaluated 20 patients with severe or refractory AOSD treated with at least one biological agent (anakinra, etanercept, tocilizumab, and adalimumab), followed up for at least 12 months at our Institution. We collected and analysed data on the disease course, treatment outcome, and adverse effects, and compared our data with other published series. RESULTS: The median duration of follow-up was 5 years. In 12 patients a single biological drug induced a clinical response. In eight patients the biological agent that was first administered proved ineffective, and a switch to a different biologic was necessary. In three patients a third biologic was necessary to achieve disease control. The biologics eventually determined a clinical response in all patients. Patients with systemic disease showed better responses than patients with chronic articular disease (p < 0.05). Biological agents allowed either the withdrawal or the tapering of corticosteroid therapy (p < 0.0001) and of disease-modifying anti-rheumatic agents (DMARDs; p < 0.05). Three patients experienced herpes zoster reactivation. CONCLUSIONS: This is the longest follow-up of a cohort of AOSD patients treated with biological agents. Our data show that biologics are safe and generally effective in the long-term management of AOSD, particularly in cases with systemic disease, and suggest that a clinical response can be obtained in almost all AOSD patients, although a switch to drugs with a different mechanism of action may be necessary.
Authors: Giulio Cavalli; Jamie N Justice; Kristen E Boyle; Angelo D'Alessandro; Elan Z Eisenmesser; Jonathan J Herrera; Kirk C Hansen; Travis Nemkov; Rinke Stienstra; Cecilia Garlanda; Alberto Mantovani; Douglas R Seals; Lorenzo Dagna; Leo A B Joosten; Dov B Ballak; Charles A Dinarello Journal: Proc Natl Acad Sci U S A Date: 2017-02-13 Impact factor: 11.205
Authors: Fréderic Franconieri; Samuel Deshayes; Hubert de Boysson; Salim Trad; Nicolas Martin Silva; Benjamin Terrier; Boris Bienvenu; Françoise Galateau-Sallé; Jean-François Emile; Alison C Johnson; Achille Aouba Journal: Oncoimmunology Date: 2018-04-09 Impact factor: 8.110
Authors: Francisco Ortiz-Sanjuán; Ricardo Blanco; Leyre Riancho-Zarrabeitia; Santos Castañeda; Alejandro Olivé; Anne Riveros; María L Velloso-Feijoo; Javier Narváez; Inmaculada Jiménez-Moleón; Olga Maiz-Alonso; Carmen Ordóñez; José A Bernal; María V Hernández; Walter A Sifuentes-Giraldo; Catalina Gómez-Arango; Eva Galíndez-Agirregoikoa; Juan Blanco-Madrigal; Vera Ortiz-Santamaria; Jordi Del Blanco-Barnusell; Juan R De Dios; Mireia Moreno; Jordi Fiter; Marina de Los Riscos; Patricia Carreira; María J Rodriguez-Valls; M Carmen González-Vela; Vanesa Calvo-Río; Javier Loricera; Natalia Palmou-Fontana; Trinitario Pina; Javier Llorca; Miguel A González-Gay Journal: Medicine (Baltimore) Date: 2015-09 Impact factor: 1.817