Background Canakinumab (CAN) had demonstrated its efficacy and safety in SJIA pts (1).
Objectives To report on the experience with CAN treatment in SJIA in the clinical practice in Germany.
Methods Data on patients' and disease characteristics, disease activity and safety reports from the German BIKER registry were analysed.
Results Until Dec. 2016, 37 pts exposed to CAN were identified. In 12 pts used CAN as first biologic, 25 pts were pretreated: Tocilizumab 15, Anakinra 11, Etanercept 9, Adalimumab 9. 3 patients in the pre-exposed cohort had experienced a macrophage activation syndrome. Pts' and disease characteristics are outlined in table 1. Pts pretreated were older, had a longer disease duration and more comorbidities than naïve patients. The proportion of pts with active arthritis, active systemic features and both were comparable. Disease activity at baseline was higher in the naïve cohort suggesting some clinical benefit from pretreatment. Dosing of CAN was comparable (3.9+/-0.4 vs. 3.5+/-0.7mg/kg) as well as the median treatment duration (0.8vs.1year). Treatment efficacy at last follow up was better in the naïve cohort with more pts reaching a PedACR 30/50/70/90 response while JADAS- or ACR-remission rates were comparable. Treatment was discontinued by 42% in the naïve and 48% in the exposed cohort. Reasons were inefficacy (n=7;19%), intolerance (n=2;5%) and remission (n=7;19%) of the disease and other (n=2;5%).
Conclusions First experience with CAN for treatment of sJIA in clinical practice is presented. A high proportion of pts gained significant improvement. JADAS remission was reached by about 50% and ACR remission by 25–57% in both biologics pre-exposed and naïve pts while few pts discontinued treatment in remission so far. Intolerance was rare. The further long term surveillance of sJIA pts exposed CAN is intended by the registry.
Ruperto N, Brunner HI, Quartier P, et al. Two randomized trials of canakinumab in systemic juvenile idiopathic arthritis. N Engl J Med 2012;367(25):2396–406.
Acknowledgements The authors thank I.Foeldvari, M.Hufnagel, J.Kuemmerle-Deschner, F.Weller-Heinemann, M.Sailer-Hoeck, A.Hospach, G.Heubner, C.Rietschel and B-U.Keck for contributing to the Canakinumab cohort. The German Registry is supported by an unrestricted grant from Abbvie, Germany Novartis, Germany, and Roche, Germany.
Disclosure of Interest G. Horneff Speakers bureau: Abbvie, Novartis, Chugai, F. Dressler Speakers bureau: Novartis, Pfizer, A. Thon: None declared, K. Minden Speakers bureau: Abbvie, Pfizer,Roche,Genzyme,Pharm-Allergan