Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review
| Autor: | Maria Victoria Hernández, J. M. Blanco-Madrigal, Walter Alberto Sifuentes-Giraldo, Ricardo Blanco, Trinitario Pina, Eva Galíndez-Agirregoikoa, Vera Ortiz-Santamaria, Anne Riveros, Inmaculada Jiménez-Moleón, María Luisa Velloso-Feijoó, Natalia Palmou-Fontana, O. Maiz-Alonso, Santos Castañeda, J.A. Bernal, Jordi del Blanco-Barnusell, Catalina Gomez-Arango, Juan Ramon De Dios, Miguel A. González-Gay, Jordi Fiter, Marina de los Riscos, Patricia Carreira, Francisco Ortiz-Sanjuán, Javier Narváez, Alejandro Olivé, M. Carmen González-Vela, Mireia Moreno, Javier Llorca, Carmen Ordóñez, María J. Rodriguez-Valls, Javier Loricera, Leyre Riancho-Zarrabeitia, Vanesa Calvo-Río |
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| Přispěvatelé: | [Ortiz-Sanjuán,F, Blanco,R, Riancho-Zarrabeitia,L, González-Vela,MC, Calvo-Río,V, Loricera,J, Palmou-Fontana,N, Pina,T, González-Gay,MA] Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander. [Castañeda,S] Hospital Universitario de La Princesa, IIS Princesa Madrid, Madrid. [Olivé,A, Riveros,A] Hospital Universitario Germans Trias i Pujol, Badalona. [Velloso-Feijoo,ML] Hospital Valme, Sevilla. [Narváez,J] Hospital Universitario de Bellvitge Hospitalet, Barcelona. [Jiménez-Moleón,I] Hospital San Cecilio, Granada. [Maiz-Alonso,O] HU Donostia, San Sebastián. [Ordóñez,C] HRU Carlos Haya, Málaga. [Bernal,JA] HGU, Alicante, Alicante. [Hernández,MV] Hospital Clinic of Barcelona, Barcelona. [Sifuentes-Giraldo,WA] Hospital Ramón y Cajal, Madrid. [Gómez-Arango,C, Galíndez-Agirregoikoa,E, Blanco-Madrigal,J] Hospital Universitario Basurto, Bilbao. [Ortiz-Santamaria,V] Hospital General Granollers, Granollers, Spain. [del Blanco-Barnusell,J] H Sant Jaume, Calella. [De Dios,JD] HU Álava, Vitoria. [Moreno,M] HU Parc Taulí, Sabadell. [Fiter,J] HU Son Espases, Palma de Mallorca, Mallorca. [de los Riscos,M, Carreira,P] Hospital Universitario 12 de Octubre, Madrid. [Rodriguez-Valls,MJ] Hospital de Jerez, Jerez. [Llorca,JL] Universidad de Cantabria, IDIVAL, Santander. CIBER Epidemiology and Public Health (CIBERESP), Santander Spain., Universitat de Barcelona, Universidad de Cantabria |
| Jazyk: | angličtina |
| Rok vydání: | 2015 |
| Předmět: |
Male
Analytical Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies [Medical Subject Headings] humanos inmunosupresores Gastroenterology Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans [Medical Subject Headings] Interquartile range Prednisone Quimioterapia combinada Ús terapèutic Masculino mediana edad Chemicals and Drugs::Amino Acids Peptides and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Interleukin 1 Receptor Antagonist Protein [Medical Subject Headings] Adult-Onset Still's Disease Leukopenia Adulto farmacoterapia Femenino Reumatologia Drugs General Medicine adulto Middle Aged Rash Rare diseases Humanos proteína antagonista del receptor de interleucina 1 Anakinra Estudi de casos Proteína antagonista del receptor de interleucina 1 Drug Therapy Combination Female Malalties rares medicine.symptom Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents [Medical Subject Headings] Still's Disease Adult-Onset Immunosuppressive Agents Medicaments Research Article medicine.drug Adult medicine.medical_specialty Anemia Diseases::Immune System Diseases::Autoimmune Diseases::Arthritis Rheumatoid::Still's Disease Adult-Onset [Medical Subject Headings] Observational Study Analytical Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy Combination [Medical Subject Headings] Check Tags::Male [Medical Subject Headings] Artritis reumatoide Estudios retrospectivos Pharmacotherapy Drug Therapy Rheumatology Refractory Internal medicine medicine Humans Persons::Persons::Age Groups::Adult [Medical Subject Headings] Retrospective Studies Mediana edad business.industry Enfermedad de Still del adulto estudios retrospectivos Therapeutic use Persons::Persons::Age Groups::Adult::Middle Aged [Medical Subject Headings] medicine.disease Inmunosupresores Surgery Interleukin 1 Receptor Antagonist Protein Chemicals and Drugs::Polycyclic Compounds::Steroids::Pregnanes::Pregnadienes::Pregnadienediols::Prednisone [Medical Subject Headings] Check Tags::Female [Medical Subject Headings] Prednisona AOSD Case studies prednisona business |
| Zdroj: | Recercat. Dipósit de la Recerca de Catalunya instname Medicine (Baltimore) 2015 Sep;94(39):e1554 UCrea Repositorio Abierto de la Universidad de Cantabria Universidad de Cantabria (UC) Dipòsit Digital de la UB Universidad de Barcelona Dipòsit Digital de Documents de la UAB Universitat Autònoma de Barcelona Repositorio Institucional de la Consejería de Sanidad de la Comunidad de Madrid Consejería de Sanidad de la Comunidad de Madrid Medicine |
| Popis: | Adult-onset Still's disease (AOSD) is often refractory to standard therapy. Anakinra (ANK), an interleukin-1 receptor antagonist, has demonstrated efficacy in single cases and small series of AOSD. We assessed the efficacy of ANK in a series of AOSD patients.Multicenter retrospective open-label study. ANK was used due to lack of efficacy to standard synthetic immunosuppressive drugs and in some cases also to at least 1 biologic agent.Forty-one patients (26women/15 men) were recruited. They had a mean age of 34.414 years and a median [interquartile range (IQR)] AOSD duration of 3.5 [2-6] years before ANK onset. At that time the most common clinical features were joint manifestations 87.8%, fever 78%, and cutaneous rash 58.5%. ANK yielded rapid and maintained clinical and laboratory improvement. After 1 year of therapy, the frequency of joint and cutaneous manifestations had decreased to 41.5% and to 7.3% respectively, fever from 78% to 14.6%, anemia from 56.1% to 9.8%, and lymphadenopathy from 26.8% to 4.9%. A dramatic improvement of laboratory parameters was also achieved. The median [IQR] prednisone dose was also reduced from 20 [11.3-47.5] mg/day at ANK onset to 5 [0-10] at 12 months. After a median [IQR] follow-up of 16 [5-50] months, the most important side effects were cutaneous manifestations (n=8), mild leukopenia (n=3), myopathy (n=1), and infections (n=5).ANK is associated with rapid and maintained clinical and laboratory improvement, even in nonresponders to other biologic agents. However, joint manifestations are more refractory than the systemic manifestations. Dr MAG-G received grants/research supports from Abbott, MSD, and Roche, and had consultation fees/participation in company sponsored speaker?s bureau from Abbott, Pfizer, Roche, Janssen, Lilly, Bristol-Meiers, and MSD.; Dr FO-S received grants/research supports from Abbvie.; This work was also partially supported by RETICS Programs, RD08/0075 (RIER), and RD12/0009/0013 from Instituto de Salud Carlos III (ISCIII) (Spain). |
| Databáze: | OpenAIRE |
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