Background: Anakinra treatment has been reported to be effective in some patients with Systemic-onset Juvenile Idiopathic Arthritis (SoJIA) or Adult-onset Still's Disease (AoSD).
Objectives: To assess the efficacy and the safety of anakinra treatment in SoJIA and AoSD. Methods: SoJIA and AoSD patients were treated with anakinra (1 to 2 mg/kg per day in children, 100 mg/day in adults); we analysed its effect on fever, ESR and CRP levels, numbers of swollen and tender joints, the assessment of disease activity (by physician and parent/patient) and pain (by parent/patient), and ACR pedi core set criteria for JIA activity.
Results: Thirty-five patients were included, 20 with SoJIA and 15 with AoSD: their mean age [range] at the onset of treatment was 12.4 [3-23] and 38.1 [22-62] years, respectively; their disease duration was 7.0 [1-16] and 7.8 [2-27] years, respectively. Active arthritis was present in all cases but one. Five of the 20 SoJIA patients achieved ACR50 response criteria at 6 months. Steroid dose had been decreased by 15% to 78% in 10 cases. Eleven of the 15 AoSD patients achieved at least a 50% improvement for all disease markers (mean follow-up: 17.5 [11- 27] months). Steroids had been stopped in 2 cases and the dose was decreased by 45% to 95% in 12 patients. Two patients stopped anakinra due to severe skin-reaction and 2 patients due to infection: one visceral leishmaniasis and one varicella.
Conclusion: Anakinra was effective in most AoSD patients, but less than half SoJIA patients achieved a marked and sustained improvement.
- adult onset Still's disease
- juvenile arthritis