RESEARCH - Treatment with Kineret (anakinra) in patients with SoJIA or AoSD

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Ann Rheum Dis. 2008 Mar;67(3):302-8. Epub 2007 Oct 18.

Interleukin-1 receptor antagonist (anakinra) treatment in patients

with systemic-onset juvenile idiopathic arthritis or adult onset Still

disease: preliminary experience in France.

Lequerré T, Quartier P, Rosellini D, Alaoui F, De Bandt M, Mejjad O,

Kone-Paut I, Michel M, Dernis E, Khellaf M, Limal N, Job-Deslandre C,

Fautrel B, Le Loët X, Sibilia J; Société Francophone pour la

Rhumatologie et les Maladies Inflammatoires en Pédiatrie (SOFREMIP);

Club Rhumatismes et Inflammation (CRI).

Rheumatology Department, Rouen University Hospital & Inserm 905, 76031

Rouen, France.

BACKGROUND: Anakinra treatment has been reported to be effective in

some patients with systemic-onset juvenile idiopathic arthritis

(SoJIA) or adult-onset Still disease (AoSD). OBJECTIVES: To assess the

efficacy and the safety of anakinra treatment in SoJIA and AoSD.

METHODS: SoJIA and AoSD patients were treated with anakinra (1-2

mg/kg/day in children, 100 mg/day in adults); we analysed its effect

on fever, erythrocyte sedimentation rate (ESR) and C-reactive protein

(CRP) levels, numbers of swollen and tender joints, the assessment of

disease activity (by physician and parent/patient) and pain (by

parent/patient), and American College of Rheumatology (ACR) pediatric

core set criteria for JIA activity. RESULTS: A total of 35 patients

were included, 20 with SoJIA and 15 with AoSD. Their mean age (range)

at the onset of treatment was 12.4 (3-23) and 38.1 (22-62) years,

respectively; disease duration was 7.0 (1-16) and 7.8 (2-27) years,

respectively. Active arthritis was present in all cases but one. Of

the 20 SoJIA patients, 5 achieved ACR 50% improvement in symptoms

(ACR50) response criteria at 6 months. Steroid dose had been decreased

by 15% to 78% in 10 cases. A total of 11 of the 15 AoSD patients

achieved at least a 50% improvement for all disease markers (mean

follow-up: 17.5 (11-27) months). Steroids had been stopped in two

cases and the dose was decreased by 45% to 95% in 12 patients. Two

patients stopped anakinra due to severe skin reaction, and two

patients due to infection: one visceral leishmaniasis and one

varicella.

CONCLUSION: Anakinra was effective in most AoSD patients, but less

than half SoJIA patients achieved a marked and sustained improvement.

PMID: 17947302

http://www.ncbi.nlm.nih.gov/pubmed/17947302

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