PMID- 31507416
OWN - NLM
STAT- PubMed-not-MEDLINE
LR  - 20201001
IS  - 1663-9812 (Print)
IS  - 1663-9812 (Electronic)
IS  - 1663-9812 (Linking)
VI  - 10
DP  - 2019
TI  - Anakinra Drug Retention Rate and Predictive Factors of Long-Term Response in 
      Systemic Juvenile Idiopathic Arthritis and Adult Onset Still Disease.
PG  - 918
LID - 10.3389/fphar.2019.00918 [doi]
LID - 918
AB  - Background and Objective: Only a few studies have reported long-term efficacy of 
      interleukin (IL)-1 inhibition in systemic juvenile idiopathic arthritis (sJIA) 
      and adult-onset Still disease (AOSD). Herein we report on the effectiveness of 
      anakinra (ANA), expressed in terms of drug retention rate (DRR), and evaluate the 
      predictive factors of drug survival in a cohort of patients with sJIA and AOSD. 
      Patients and Methods: This is a multicenter study reviewing retrospectively the 
      medical records from 61 patients with sJIA and 76 with AOSD, all treated with ANA 
      in 25 Italian tertiary referral centers. Results: The cumulative retention rate 
      of ANA at 12-, 24-, 48-, and 60-month of follow-up was 74.3%, 62.9%, 49.4%, and 
      49.4%, respectively, without any significant differences between sJIA and AOSD 
      patients (p = 0.164), and between patients treated in monotherapy compared with 
      the subgroup coadministered with conventional disease-modifying antirheumatic 
      drugs (cDMARDs) (p = 0.473). On the other hand, a significant difference in DRR 
      was found between biologic-naive patients and those previously treated with 
      biotechnologic drugs (p = 0.009), which persisted even after adjustment for 
      pathology (p = 0.013). In the regression analysis, patients experiencing adverse 
      events (AEs) hazards ratio (HR) = 3.029 [confidence interval (CI) 1.750-5.242], 
      p < 0.0001 and those previously treated with other biologic agents [HR = 1.818 
      (CI 1.007-3.282), p = 0.047] were associated with a higher HR of ANA 
      discontinuation. The median treatment delay was significantly higher among 
      patients discontinuing ANA (p < 0.0001). Significant corticosteroid-sparing (p = 
      0.033) and cDMARD-sparing effects (p < 0.0001) were also recorded. Less than 
      one-third of our cohort developed AEs, and 85% were deemed mild in nature, with 
      70% of them involving the skin. Conclusions: Our findings display an overall 
      excellent DRR of ANA on the long run for both sJIA and AOSD, that may be further 
      optimized by closely monitoring patient's safety issues and employing this IL-1 
      inhibitor as a first-line biologic as early as possible. Moreover, ANA allowed a 
      significant drug-sparing effect and showed an overall good safety profile.
FAU - Sota, Jurgen
AU  - Sota J
AD  - Research Center of Systemic Autoinflammatory Diseases and Behcet's Disease 
      Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of 
      Siena, Siena, Italy.
FAU - Rigante, Donato
AU  - Rigante D
AD  - Institute of Pediatrics, Fondazione Policlinico A. Gemelli IRCCS, Rome, Italy.
AD  - Periodic Fever Research Center, Universita Cattolica Sacro Cuore, Rome, Italy.
FAU - Ruscitti, Piero
AU  - Ruscitti P
AD  - Division of Rheumatology, Department of Biotechnological and Applied Clinical 
      Science, University of L'Aquila, L'Aquila, Italy.
FAU - Insalaco, Antonella
AU  - Insalaco A
AD  - Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesu 
      Children's Hospital IRCCS, Rome, Italy.
FAU - Sfriso, Paolo
AU  - Sfriso P
AD  - Rheumatology Unit, Department of Medicine, University of Padua, Padua, Italy.
FAU - de Vita, Salvatore
AU  - de Vita S
AD  - Department of Medical and Biological Sciences, Rheumatology Clinic, University of 
      Udine, Udine, Italy.
FAU - Cimaz, Rolando
AU  - Cimaz R
AD  - Rheumatology Unit, Meyer Children's Hospital, University of Florence, Florence, 
      Italy.
FAU - Lopalco, Giuseppe
AU  - Lopalco G
AD  - Department of Emergency and Organ Transplantation-Rheumatology Unit, University 
      of Bari, Bari, Italy.
FAU - Emmi, Giacomo
AU  - Emmi G
AD  - Department of Experimental and Clinical Medicine, University of Florence, 
      Florence, Italy.
FAU - La Torre, Francesco
AU  - La Torre F
AD  - Pediatric Rheumatology Section, Pediatric Unit, Giovanni XXIII - Pediatric 
      Hospital, Bari, Italy.
FAU - Fabiani, Claudia
AU  - Fabiani C
AD  - Ophthalmology Unit, Department of Medicine, Surgery and Neuroscience, University 
      of Siena, Siena, Italy.
FAU - Olivieri, Alma Nunzia
AU  - Olivieri AN
AD  - Dipartimento della donna del bambino e di chirurgia generale e specialistica, 
      Universita della Campania Luigi Vanvitelli, Italy.
FAU - Cattalini, Marco
AU  - Cattalini M
AD  - Pediatric Clinic, University of Brescia and Spedali Civili di Brescia, Brescia, 
      Italy.
FAU - Cammelli, Daniele
AU  - Cammelli D
AD  - Experimental and Clinical Medicine Department, University of Florence, Florence, 
      Italy.
FAU - Gallizzi, Romina
AU  - Gallizzi R
AD  - Department of Pediatrics, Azienda G. Martino, University of Messina, Messina, 
      Italy.
FAU - Alessio, Maria
AU  - Alessio M
AD  - Department of Pediatrics, University Federico II, Naples, Italy.
FAU - Manna, Raffaele
AU  - Manna R
AD  - Periodic Fever Research Center, Universita Cattolica Sacro Cuore, Rome, Italy.
FAU - Viapiana, Ombretta
AU  - Viapiana O
AD  - Rheumatology Section, Department of Medicine, University of Verona, Verona, 
      Italy.
FAU - Frassi, Micol
AU  - Frassi M
AD  - Rheumatology and Clinical Immunology Unit, Department of Clinical and 
      Experimental Sciences, University of Brescia and Spedali Civili di Brescia, 
      Brescia, Italy.
FAU - Pardeo, Manuela
AU  - Pardeo M
AD  - Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesu 
      Children's Hospital IRCCS, Rome, Italy.
FAU - Maier, Armin
AU  - Maier A
AD  - Struttura Semplice di Reumatologia, Ospedale di Bolzano, Bolzano, Italy.
FAU - Salvarani, Carlo
AU  - Salvarani C
AD  - Rheumatology Unit, Department of Internal Medicine, Azienda Ospedaliera ASMN 
      IRCCS, Reggio Emilia, Italy.
FAU - Talarico, Rosaria
AU  - Talarico R
AD  - Rheumatology Unit, Department of Clinical and Experimental Medicine, University 
      of Pisa, Pisa, Italy.
FAU - Mosca, Marta
AU  - Mosca M
AD  - Rheumatology Unit, Department of Clinical and Experimental Medicine, University 
      of Pisa, Pisa, Italy.
FAU - Colafrancesco, Serena
AU  - Colafrancesco S
AD  - Department of Internal Medicine and Medical Specialties, Rheumatology Unit, 
      Sapienza University of Rome, Rome, Italy.
FAU - Priori, Roberta
AU  - Priori R
AD  - Department of Internal Medicine and Medical Specialties, Rheumatology Unit, 
      Sapienza University of Rome, Rome, Italy.
FAU - Maggio, Maria Cristina
AU  - Maggio MC
AD  - Universitary Department "Pro.S.A.M.I.", University of Palermo, Palermo, Italy.
FAU - Gaggiano, Carla
AU  - Gaggiano C
AD  - Clinical Pediatrics, Department of Molecular Medicine and Development, University 
      of Siena, Siena, Italy.
FAU - Grosso, Salvatore
AU  - Grosso S
AD  - Clinical Pediatrics, Department of Molecular Medicine and Development, University 
      of Siena, Siena, Italy.
FAU - De Benedetti, Fabrizio
AU  - De Benedetti F
AD  - Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesu 
      Children's Hospital IRCCS, Rome, Italy.
FAU - Vitale, Antonio
AU  - Vitale A
AD  - Research Center of Systemic Autoinflammatory Diseases and Behcet's Disease 
      Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of 
      Siena, Siena, Italy.
FAU - Giacomelli, Roberto
AU  - Giacomelli R
AD  - Division of Rheumatology, Department of Biotechnological and Applied Clinical 
      Science, University of L'Aquila, L'Aquila, Italy.
FAU - Cantarini, Luca
AU  - Cantarini L
AD  - Research Center of Systemic Autoinflammatory Diseases and Behcet's Disease 
      Clinic, Department of Medical Sciences, Surgery and Neurosciences, University of 
      Siena, Siena, Italy.
LA  - eng
PT  - Journal Article
DEP - 20190823
PL  - Switzerland
TA  - Front Pharmacol
JT  - Frontiers in pharmacology
JID - 101548923
PMC - PMC6715768
OTO - NOTNLM
OT  - adult onset Still disease
OT  - anakinra
OT  - drug retention rate
OT  - innovative biotechnologies
OT  - interleukin 1-beta
OT  - personalized medicine
OT  - systemic juvenile idiopathic arthritis
EDAT- 2019/09/12 06:00
MHDA- 2019/09/12 06:01
PMCR- 2019/08/23
CRDT- 2019/09/12 06:00
PHST- 2019/04/04 00:00 [received]
PHST- 2019/07/22 00:00 [accepted]
PHST- 2019/09/12 06:00 [entrez]
PHST- 2019/09/12 06:00 [pubmed]
PHST- 2019/09/12 06:01 [medline]
PHST- 2019/08/23 00:00 [pmc-release]
AID - 10.3389/fphar.2019.00918 [doi]
PST - epublish
SO  - Front Pharmacol. 2019 Aug 23;10:918. doi: 10.3389/fphar.2019.00918. eCollection 
      2019.