Manuela Pardeo1, Denise Pires Marafon2, Antonella Insalaco2, Claudia Bracaglia2, Rebecca Nicolai2, Virginia Messia2, Fabrizio De Benedetti1. 1. From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS. manuela.pardeo@opbg.net fabrizio.debenedetti@opbg.net. 2. From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
Abstract
OBJECTIVE: To assess anakinra as a therapy for systemic juvenile idiopathic arthritis (sJIA) in a single-center series. METHODS: We reviewed 25 patients with sJIA treated with anakinra for at least 6 months. The primary outcome was the number of patients who achieved clinically inactive disease at 6 months, according to preliminary criteria for inactive disease and clinical remission of JIA. RESULTS: Among 25 patients evaluated, 14 (56%) met the criteria for inactive disease at 6 months and were classified as responders. For each individual patient, we compared the dose administered with the ideal dose of anakinra and we found that there was no relation with response. We also compared demographic characteristics and clinical and laboratory features at baseline in responders and non-responders: no differences were observed in relation with the number of active joints before starting anakinra or concomitant glucocorticoids treatment. The only variable significantly associated with response was the time from disease onset to receiving anakinra, with earlier treatment being associated with a better outcome. CONCLUSION: Anakinra is associated with rapid attainment of inactive disease in a significant portion of patients. We found that only the earlier treatment is associated with better outcome. However, formal studies on early treatment and on the pathophysiology and response to treatments, including anakinra, of early- and late-onset sJIA are needed to optimize the management of this challenging disease.
OBJECTIVE: To assess anakinra as a therapy for systemic juvenile idiopathic arthritis (sJIA) in a single-center series. METHODS: We reviewed 25 patients with sJIA treated with anakinra for at least 6 months. The primary outcome was the number of patients who achieved clinically inactive disease at 6 months, according to preliminary criteria for inactive disease and clinical remission of JIA. RESULTS: Among 25 patients evaluated, 14 (56%) met the criteria for inactive disease at 6 months and were classified as responders. For each individual patient, we compared the dose administered with the ideal dose of anakinra and we found that there was no relation with response. We also compared demographic characteristics and clinical and laboratory features at baseline in responders and non-responders: no differences were observed in relation with the number of active joints before starting anakinra or concomitant glucocorticoids treatment. The only variable significantly associated with response was the time from disease onset to receiving anakinra, with earlier treatment being associated with a better outcome. CONCLUSION: Anakinra is associated with rapid attainment of inactive disease in a significant portion of patients. We found that only the earlier treatment is associated with better outcome. However, formal studies on early treatment and on the pathophysiology and response to treatments, including anakinra, of early- and late-onset sJIA are needed to optimize the management of this challenging disease.
Authors: Lauren A Henderson; Kacie J Hoyt; Pui Y Lee; Deepak A Rao; A Helena Jonsson; Jennifer P Nguyen; Kayleigh Rutherford; Amélie M Julé; Louis-Marie Charbonnier; Siobhan Case; Margaret H Chang; Ezra M Cohen; Fatma Dedeoglu; Robert C Fuhlbrigge; Olha Halyabar; Melissa M Hazen; Erin Janssen; Susan Kim; Jeffrey Lo; Mindy S Lo; Esra Meidan; Mary Beth F Son; Robert P Sundel; Matthew L Stoll; Chad Nusbaum; James A Lederer; Talal A Chatila; Peter A Nigrovic Journal: JCI Insight Date: 2020-03-26
Authors: Lianne Kearsley-Fleet; Michael W Beresford; Rebecca Davies; Diederik De Cock; Eileen Baildam; Helen E Foster; Taunton R Southwood; Wendy Thomson; Kimme L Hyrich Journal: Rheumatology (Oxford) Date: 2019-01-01 Impact factor: 7.580
Authors: Gail H Deutsch; R Paul Guillerman; Johannes Birgmeier; Karthik Jagadeesh; Scott Canna; Grant Schulert; Vivian E Saper; Guangbo Chen; Robin Deterding; Jianpeng Xu; Ann N Leung; Layla Bouzoubaa; Khalid Abulaban; Kevin Baszis; Edward M Behrens; James Birmingham; Alicia Casey; Michal Cidon; Randy Q Cron; Aliva De; Fabrizio De Benedetti; Ian Ferguson; Martha P Fishman; Steven I Goodman; T Brent Graham; Alexei A Grom; Kathleen Haines; Melissa Hazen; Lauren A Henderson; Assunta Ho; Maria Ibarra; Christi J Inman; Rita Jerath; Khulood Khawaja; Daniel J Kingsbury; Marisa Klein-Gitelman; Khanh Lai; Sivia Lapidus; Clara Lin; Jenny Lin; Deborah R Liptzin; Diana Milojevic; Joy Mombourquette; Karen Onel; Seza Ozen; Maria Perez; Kathryn Phillippi; Sampath Prahalad; Suhas Radhakrishna; Adam Reinhardt; Mona Riskalla; Natalie Rosenwasser; Johannes Roth; Rayfel Schneider; Dieneke Schonenberg-Meinema; Susan Shenoi; Judith A Smith; Hafize Emine Sönmez; Matthew L Stoll; Christopher Towe; Sara O Vargas; Richard K Vehe; Lisa R Young; Jacqueline Yang; Tushar Desai; Raymond Balise; Ying Lu; Lu Tian; Gill Bejerano; Mark M Davis; Purvesh Khatri; Elizabeth D Mellins Journal: Ann Rheum Dis Date: 2019-09-27 Impact factor: 19.103