Experiences with IL-1 blockade in systemic juvenile idiopathic arthritis - data from the German AID-registry.

Autor: Lainka E; Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany. elke.lainka@uni-due.de., Baehr M; Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany., Raszka B; Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany., Haas JP; German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany., Hügle B; German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany., Fischer N; German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany., Foell D; Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany., Hinze C; Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany., Weissbarth-Riedel E; Pediatric Rheumatology, University Children's Hospital Hamburg-Eppendorf, Hamburg, Germany., Kallinich T; Department of Pediatric Pneumology, Immunology and Intensive Medicine and Center for Chronically Sick Children, Charité University Medicine Berlin and German Rheumatism Research Centre Berlin, Berlin, Germany., Horneff G; Department of Pediatrics, Asklepios Clinic, Centre for Pediatric Rheumatology, St. Augustin and Medical Faculty, University of Cologne, Cologne, Germany., Windschall D; Department of Pediatric Rheumatology, St. Josef Hospital, Sendenhorst, Germany., Lilienthal E; Department of Pediatrics, Ruhr-University Bochum, Bochum, Germany., Niehues T; HELIOS Children's Hospital, Pediatric Immunology and Rheumatology, Krefeld, Germany., Neudorf U; Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany., Berendes R; Department of Pediatric Rheumatology, St. Marien's Children's Hospital Landshut, Landshut, Germany., Küster RM; Orthopedics centre Altona and Pediatric practice Rissen, Hamburg, Germany., Oommen PT; Department of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany., Rietschel C; Department of Pediatrics, Clementine Children's Hospital Frankfurt, Frankfurt, Germany., Lutz T; Center for Pediatric and Adolescent Medicine/Pediatric Rheumatology, University Hospital Heidelberg, Heidelberg, Germany., Weller-Heinemann F; Division of Pediatric Rheumatology, Prof. Hess Children's Hospital, Bremen, Germany., Tenbrock K; Department of Pediatric Pneumology, Allergology and Immunology, RWTH Aachen, Aachen, Germany., Heubner GL; Department of Pediatrics, Municipal Hospital Dresden, Dresden, Germany., Klotsche J; German Rheumatism Research Centre Berlin, Berlin, Germany., Wittkowski H; Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany.
Jazyk: angličtina
Zdroj: Pediatric rheumatology online journal [Pediatr Rheumatol Online J] 2021 Mar 22; Vol. 19 (1), pp. 38. Date of Electronic Publication: 2021 Mar 22.
DOI: 10.1186/s12969-021-00510-8
Abstrakt: Background: Systemic juvenile idiopathic arthritis (sJIA) is a complex disease with dysregulation of the innate immune system driven by cytokines. A major role is ascribed to interleukin-1β (IL-1β), supporting the autoinflammatory character of the disease and offering an effective blocking mechanism for treatment. Here we present clinical practice data from the German AID-registry for patients treated with IL-1 inhibition (IL-1i).
Methods: In 2009 a clinical and research consortium (AID-Net) was established, including an online AID-registry. Patients with documented sJIA diagnosis were identified. Data for this retrospective IL-1i study were recorded by 17 centers. Response to treatment was evaluated according to Wallace criteria and additionally by an own classifying clinical response system.
Results: In 6 years, 202 patients with confirmed sJIA were recorded in the AID-registry. Out of these, 111 children received therapy with Anakinra (ANA) (n = 84, 39 f) and/or Canakinumab (CANA) (n = 27, 15 f) at a median age of 8.7 y (range 0.6-19.1). During the first 12 months 75/111 (ANA 55, CANA 20) patients were evaluated according to Wallace criteria (achievement of inactive disease 28/55 and 17/20, remission over 6 months under medication 13/55 and 7/20 cases). Over the whole period of time, clinical response was preserved in the majority of patients (ANA 54/80, CANA 20/27). Arthritis mostly persisted in polyarticular (PA) courses. During treatment with IL-1i concomitant medication could be tapered in about 15%. IL-1i was discontinued in 59/111 patients. 45 (15) adverse events (AE)s in ANA (CANA) treated patients (19.7 (26.6) AE/100 ANA (CANA) exposure years, 95%CI: 14.4-26.4 (14.9-43.9)) were reported.
Conclusion: In a large cohort of sJIA patients from Germany, we can confirm an overall favorable clinical response to both available IL-1 blocking agents. IL-1i was well tolerated with acceptable safety and effectiveness in a real-life clinical setting.
Databáze: MEDLINE
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