Safety and efficacy of anakinra as first-line or second-line therapy for systemic onset juvenile idiopathic arthritis - data from the German BIKER registry.
Background: The IL-1 receptor-antagonist anakinra is recommended for the treatment of systemic juvenile idiopathic arthritis (sJIA) and was recently approved for first-line treatment. Long-term data from clinical practise are scarce. Methods: SJIA patients from the German biologics in pediatric rheumatology (BIKER) registry starting anakinra were grouped into two cohorts: Patients in the first-line cohort received no prior sJIA treatment except NSAID and a maximum of 3 days of steroids. Second-line cohort patients were pre-treated with steroids; DMARDs or biologics. Patient characteristics, disease-activity parameters, efficacy, and safety-parameters were compared. Results: Until December 2018, 51 anakinra patients were documented, representing 117.96 patient-years. Mean disease duration was 3.5 (± 3.8) years. At baseline, all anakinra first-line users had active systemic disease compared to 82% in the second-line users. Significant JADAS-10 improvement at last follow-up was observed in both cohorts (p = 0.02, p = 0.0014). Substantial numbers of patients in both groups reached JADAS-MDA/JADAS-remission/inactive disease (66.7%50%50% in first-liners and 60%45%70% in second-liners). Rates of serious adverse events were comparable and consistent with the overall AE profile of anakinra in patients. Conclusion: This analysis adds to the established safety profile of anakinra and demonstrates that anakinra is effective as first-line or second-line treatment.
['Atemnkeng Ntam|V|V|', 'Klein|A|A|', 'Horneff|G|G|']
D000894:Anti-Inflammatory Agents, Non-Steroidal D018501:Antirheumatic Agents D001171:Arthritis, Juvenile D002648:Child D002675:Child, Preschool D015331:Cohort Studies D005260:Female D005500:Follow-Up Studies D005858:Germany D006801:Humans D007223:Infant D053590:Interleukin 1 Receptor Antagonist Protein D008297:Male D017472:Receptors, Interleukin-1 D012042:Registries D013256:Steroids D016896:Treatment Outcome
safety anakinra Systemic juvenile idiopathic arthritis interleukin-1 inhibition still´s disease