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


Journal

Pediatric rheumatology online journal
ISSN: 1546-0096
Titre abrégé: Pediatr Rheumatol Online J
Pays: England
ID NLM: 101248897

Informations de publication

Date de publication:
22 Mar 2021
Historique:
received: 23 05 2020
accepted: 24 02 2021
entrez: 23 3 2021
pubmed: 24 3 2021
medline: 5 11 2021
Statut: epublish

Résumé

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). 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. 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. 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.

Sections du résumé

BACKGROUND 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 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 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 CONCLUSIONS
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.

Identifiants

pubmed: 33752669
doi: 10.1186/s12969-021-00510-8
pii: 10.1186/s12969-021-00510-8
pmc: PMC7986520
doi:

Substances chimiques

Antibodies, Monoclonal, Humanized 0
Antirheumatic Agents 0
Interleukin 1 Receptor Antagonist Protein 0
Interleukin-1beta 0
canakinumab 37CQ2C7X93

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

38

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Auteurs

Elke Lainka (E)

Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany. elke.lainka@uni-due.de.

Melanie Baehr (M)

Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany.

Bernadette Raszka (B)

Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany.

Johannes-Peter Haas (JP)

German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.

Boris Hügle (B)

German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.

Nadine Fischer (N)

German Center for Pediatric and Adolescent Rheumatology, Garmisch-Partenkirchen, Germany.

Dirk Foell (D)

Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany.

Claas Hinze (C)

Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany.

Elisabeth Weissbarth-Riedel (E)

Pediatric Rheumatology, University Children's Hospital Hamburg-Eppendorf, Hamburg, Germany.

Tilmann 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.

Gerd Horneff (G)

Department of Pediatrics, Asklepios Clinic, Centre for Pediatric Rheumatology, St. Augustin and Medical Faculty, University of Cologne, Cologne, Germany.

Daniel Windschall (D)

Department of Pediatric Rheumatology, St. Josef Hospital, Sendenhorst, Germany.

Eggert Lilienthal (E)

Department of Pediatrics, Ruhr-University Bochum, Bochum, Germany.

Tim Niehues (T)

HELIOS Children's Hospital, Pediatric Immunology and Rheumatology, Krefeld, Germany.

Ulrich Neudorf (U)

Department of Pediatric Rheumatology, University Children's Hospital Essen, Essen, Germany.

Rainer Berendes (R)

Department of Pediatric Rheumatology, St. Marien's Children's Hospital Landshut, Landshut, Germany.

Rolf-Michael Küster (RM)

Orthopedics centre Altona and Pediatric practice Rissen, Hamburg, Germany.

Prasad Thomas Oommen (PT)

Department of Pediatric Oncology, Hematology and Clinical Immunology, Center for Child and Adolescent Health, Medical Faculty, Heinrich-Heine-University Duesseldorf, Duesseldorf, Germany.

Christoph Rietschel (C)

Department of Pediatrics, Clementine Children's Hospital Frankfurt, Frankfurt, Germany.

Thomas Lutz (T)

Center for Pediatric and Adolescent Medicine/Pediatric Rheumatology, University Hospital Heidelberg, Heidelberg, Germany.

Frank Weller-Heinemann (F)

Division of Pediatric Rheumatology, Prof. Hess Children's Hospital, Bremen, Germany.

Klaus Tenbrock (K)

Department of Pediatric Pneumology, Allergology and Immunology, RWTH Aachen, Aachen, Germany.

Georg Leonhard Heubner (GL)

Department of Pediatrics, Municipal Hospital Dresden, Dresden, Germany.

Jens Klotsche (J)

German Rheumatism Research Centre Berlin, Berlin, Germany.

Helmut Wittkowski (H)

Department of Pediatric Rheumatology and Immunology, University of Muenster, Muenster, Germany.

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