TY - JOUR
T1 - Comparison of Early vs. Delayed Anakinra Treatment in Patients With Adult Onset Still's Disease and Effect on Clinical and Laboratory Outcomes
T2 - Frontiers in Medicine
AU - Vitale, A.
AU - Cavalli, G.
AU - Ruscitti, P.
AU - Sota, J.
AU - Colafrancesco, S.
AU - Priori, R.
AU - Valesini, G.
AU - Argolini, L.M.
AU - Baldissera, E.
AU - Bartoloni, E.
AU - Cammelli, D.
AU - Canestrari, G.
AU - Cavallaro, E.
AU - Massaro, M.G.
AU - Cipriani, P.
AU - De Marchi, G.
AU - De Vita, S.
AU - Emmi, G.
AU - Frassi, M.
AU - Gerli, R.
AU - Gremese, E.
AU - Iannone, F.
AU - Fornaro, M.
AU - Paladini, A.
AU - Lopalco, G.
AU - Manna, R.
AU - Mathieu, A.
AU - Montecucco, C.
AU - Mosca, M.
AU - Piazza, I.
AU - Piga, M.
AU - Pontikaki, I.
AU - Romano, M.
AU - Rossi, S.
AU - Rossini, M.
AU - Silvestri, E.
AU - Stagnaro, C.
AU - Talarico, R.
AU - Frediani, B.
AU - Tincani, A.
AU - Viapiana, O.
AU - Vitiello, G.
AU - Galozzi, P.
AU - Sfriso, P.
AU - Gaggiano, C.
AU - Grosso, S.
AU - Rigante, D.
AU - Dagna, L.
AU - Giacomelli, R.
AU - Cantarini, L.
AU - Rheumatology), The Working Group of Systemic Autoinflammatory Diseases of SIR (Italian Society of
N1 - Cited By :2
Export Date: 11 March 2021
Correspondence Address: Cantarini, L.; Research Center of Systemic Autoinflammatory Diseases and Behçet's Disease Clinic, Italy; email: cantariniluca@hotmail.com
Chemicals/CAS: abatacept, 332348-12-6; adalimumab, 331731-18-1, 1446410-95-2; anakinra, 143090-92-0; azathioprine, 446-86-6; C reactive protein, 9007-41-4; certolizumab pegol, 428863-50-7; colchicine, 64-86-8; cyclosporine, 59865-13-3, 63798-73-2, 79217-60-0; etanercept, 185243-69-0, 200013-86-1, 2055118-96-0; ferritin, 9007-73-2; golimumab, 476181-74-5; hydroxychloroquine, 118-42-3, 525-31-5; immunoglobulin, 9007-83-4; infliximab, 170277-31-3; leflunomide, 75706-12-6; methotrexate, 15475-56-6, 59-05-2, 7413-34-5; rituximab, 174722-31-7; salazosulfapyridine, 599-79-1; tocilizumab, 375823-41-9
PY - 2020
Y1 - 2020
N2 - Background: Aim of this study was to search for any difference in the outcome of patients with adult onset Still's disease (AOSD) treated with anakinra (ANK) in relation with the interval between disease onset and the start of anti-interleukin(IL)-1 treatment and according with the different lines of ANK treatment. Patients and Methods: One hundred and forty-one AOSD patients treated with ANK have been retrospectively assessed. Statistically significant differences (p < 0.05) were analyzed in the frequency of ANK effectiveness, primary or secondary inefficacy to ANK and rate of resolution of clinical and laboratory AOSD manifestations after 3, 6, and 12 months since ANK treatment according with different lines of treatment and different times between AOSD onset and start of ANK. Results: No significant differences were identified in the ANK effectiveness and frequency of primary or secondary inefficacy for patients starting ANK within 6 months (p = 0.19, p = 0.14, and p = 0.81, respectively) or 12 months (p = 0.37, p = 0.23, and p = 0.81, respectively) since AOSD onset compared with patients starting ANK thereafter; no significant differences were identified in ANK effectiveness and primary or secondary inefficacy according with different lines of ANK treatment (p = 0.06, p = 0.19, and p = 0.13, respectively). Patients starting ANK within 6 and 12 months since AOSD onset showed a significantly quicker decrease of erythrocyte sedimentation rate and C-reactive protein than observed among patients undergoing ANK treatment after 6 and 12 months. The number of swollen joints at the 3 month follow-up visit was significantly lower among patients undergoing ANK within 6 months since AOSD onset (p = 0.01), while no significance was identified at the 6 and 12 month assessments (p = 0.23 and p = 0.45, respectively). At the 3 and 6 month visits, the number of swollen joints was significantly higher among patients previously treated with conventional and biological disease modifying anti-rheumatic drugs (DMARDs) compared with those formerly treated only with conventional DMARDs (p < 0.017). Conclusions: Clinical and therapeutic outcomes are substantially independent of how early ANK treatment is started in AOSD patients. However, a faster ANK effectiveness in controlling systemic inflammation and resolving articular manifestations may be observed in patients benefiting from IL-1 inhibition as soon as after disease onset. © Copyright © 2020 Vitale, Cavalli, Ruscitti, Sota, Colafrancesco, Priori, Valesini, Argolini, Baldissera, Bartoloni, Cammelli, Canestrari, Cavallaro, Massaro, Cipriani, De Marchi, De Vita, Emmi, Frassi, Gerli, Gremese, Iannone, Fornaro, Paladini, Lopalco, Manna, Mathieu, Montecucco, Mosca, Piazza, Piga, Pontikaki, Romano, Rossi, Rossini, Silvestri, Stagnaro, Talarico, Frediani, Tincani, Viapiana, Vitiello, Galozzi, Sfriso, Gaggiano, Grosso, Rigante, Dagna, Giacomelli and Cantarini.
AB - Background: Aim of this study was to search for any difference in the outcome of patients with adult onset Still's disease (AOSD) treated with anakinra (ANK) in relation with the interval between disease onset and the start of anti-interleukin(IL)-1 treatment and according with the different lines of ANK treatment. Patients and Methods: One hundred and forty-one AOSD patients treated with ANK have been retrospectively assessed. Statistically significant differences (p < 0.05) were analyzed in the frequency of ANK effectiveness, primary or secondary inefficacy to ANK and rate of resolution of clinical and laboratory AOSD manifestations after 3, 6, and 12 months since ANK treatment according with different lines of treatment and different times between AOSD onset and start of ANK. Results: No significant differences were identified in the ANK effectiveness and frequency of primary or secondary inefficacy for patients starting ANK within 6 months (p = 0.19, p = 0.14, and p = 0.81, respectively) or 12 months (p = 0.37, p = 0.23, and p = 0.81, respectively) since AOSD onset compared with patients starting ANK thereafter; no significant differences were identified in ANK effectiveness and primary or secondary inefficacy according with different lines of ANK treatment (p = 0.06, p = 0.19, and p = 0.13, respectively). Patients starting ANK within 6 and 12 months since AOSD onset showed a significantly quicker decrease of erythrocyte sedimentation rate and C-reactive protein than observed among patients undergoing ANK treatment after 6 and 12 months. The number of swollen joints at the 3 month follow-up visit was significantly lower among patients undergoing ANK within 6 months since AOSD onset (p = 0.01), while no significance was identified at the 6 and 12 month assessments (p = 0.23 and p = 0.45, respectively). At the 3 and 6 month visits, the number of swollen joints was significantly higher among patients previously treated with conventional and biological disease modifying anti-rheumatic drugs (DMARDs) compared with those formerly treated only with conventional DMARDs (p < 0.017). Conclusions: Clinical and therapeutic outcomes are substantially independent of how early ANK treatment is started in AOSD patients. However, a faster ANK effectiveness in controlling systemic inflammation and resolving articular manifestations may be observed in patients benefiting from IL-1 inhibition as soon as after disease onset. © Copyright © 2020 Vitale, Cavalli, Ruscitti, Sota, Colafrancesco, Priori, Valesini, Argolini, Baldissera, Bartoloni, Cammelli, Canestrari, Cavallaro, Massaro, Cipriani, De Marchi, De Vita, Emmi, Frassi, Gerli, Gremese, Iannone, Fornaro, Paladini, Lopalco, Manna, Mathieu, Montecucco, Mosca, Piazza, Piga, Pontikaki, Romano, Rossi, Rossini, Silvestri, Stagnaro, Talarico, Frediani, Tincani, Viapiana, Vitiello, Galozzi, Sfriso, Gaggiano, Grosso, Rigante, Dagna, Giacomelli and Cantarini.
KW - adult onset Still's disease
KW - anakinra
KW - autoinflammatory diseases
KW - innovative biotechnologies
KW - interleukin-1
KW - personalized medicine
KW - systemic onset juvenile idiopathic arthritis
KW - treat to target
KW - abatacept
KW - adalimumab
KW - azathioprine
KW - C reactive protein
KW - certolizumab pegol
KW - colchicine
KW - corticosteroid
KW - cyclosporine
KW - etanercept
KW - ferritin
KW - gold salt
KW - golimumab
KW - hydroxychloroquine
KW - immunoglobulin
KW - infliximab
KW - leflunomide
KW - methotrexate
KW - nonsteroid antiinflammatory agent
KW - rituximab
KW - salazosulfapyridine
KW - tocilizumab
KW - adult
KW - adult onset Still disease
KW - arthritis
KW - Article
KW - clinical effectiveness
KW - comparative study
KW - controlled study
KW - drug retention
KW - drug withdrawal
KW - early intervention
KW - erythrocyte sedimentation rate
KW - female
KW - ferritin blood level
KW - fever
KW - follow up
KW - human
KW - joint swelling
KW - leukocytosis
KW - liver disease
KW - lymphadenitis
KW - major clinical study
KW - male
KW - myalgia
KW - pericarditis
KW - pleurisy
KW - pneumonia
KW - rash
KW - retrospective study
KW - therapy delay
KW - treatment outcome
U2 - 10.3389/fmed.2020.00042
DO - 10.3389/fmed.2020.00042
M3 - Article
VL - 7
JO - Front. Med.
JF - Front. Med.
SN - 2296-858X
M1 - 42
ER -