Drug Retention Rate and Predictive Factors of Drug Survival for Interleukin-1 Inhibitors in Systemic Juvenile Idiopathic Arthritis

Jurgen Sota, Antonella Insalaco, Rolando Cimaz, Maria Alessio, Marco Cattalini, Romina Gallizzi, Maria Cristina Maggio, Giuseppe Lopalco, Francesco La Torre, Claudia Fabiani, Manuela Pardeo, Alma Nunzia Olivieri, Paolo Sfriso, Carlo Salvarani, Carla Gaggiano, Salvatore Grosso, Claudia Bracaglia, Fabrizio De Benedetti, Donato Rigante, Luca Cantarini

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Abstract

Background and Objectives: Few studies have reported the drug retention rate (DRR) of biologic drugs in juvenile idiopathic arthritis (JIA), and none of them has specifically investigated the DRR of interleukin (IL)-1 inhibitors on systemic JIA (sJIA). This study aims to describe IL-1 inhibitors DRR and evaluate predictive factors of drug survival based on data from a real-world setting concerning sJIA. Methods: Medical records from sJIA patients treated with anakinra (ANA) and canakinumab (CAN) were retrospectively analyzed from 15 Italian tertiary referral centers. Results: Seventy seven patients were enrolled for a total of 86 treatment courses. The cumulative retention rate of the IL-1 inhibitors at 12-, 24-, 48-, and 60-months of follow-up was 79.9, 59.5, 53.5, and 53.5%, respectively, without any statistically significant differences between ANA and CAN (p = 0.056), and between patients treated in monotherapy compared to the subgroup co-administered with conventional immunosuppressors (p = 0.058). On the contrary, significant differences were found between biologic-naive patients and those previously treated with biologic drugs (p = 0.038) and when distinguishing according to adverse events (AEs) occurrence (p = 0.04). In regression analysis, patients pre-treated with other biologics (HR = 3.357 [CI: 1.341-8.406], p = 0.01) and those experiencing AEs (HR = 2.970 [CI: 1.186-7.435], p = 0.020) were associated with a higher hazard ratio of IL-1 inhibitors withdrawal. The mean treatment delay was significantly higher among patients discontinuing IL-1 inhibitors (p = 0.0002). Conclusions: Our findings suggest an excellent overall DRR for both ANA and CAN that might be further augmented by paying attention to AEs and employing these agents as first-line biologics in an early disease phase.

Original languageEnglish
Pages (from-to)1526
JournalFrontiers in Pharmacology
Volume9
DOIs
Publication statusPublished - 2018

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    Sota, J., Insalaco, A., Cimaz, R., Alessio, M., Cattalini, M., Gallizzi, R., Maggio, M. C., Lopalco, G., La Torre, F., Fabiani, C., Pardeo, M., Olivieri, A. N., Sfriso, P., Salvarani, C., Gaggiano, C., Grosso, S., Bracaglia, C., De Benedetti, F., Rigante, D., & Cantarini, L. (2018). Drug Retention Rate and Predictive Factors of Drug Survival for Interleukin-1 Inhibitors in Systemic Juvenile Idiopathic Arthritis. Frontiers in Pharmacology, 9, 1526. https://doi.org/10.3389/fphar.2018.01526