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Correspondence
Prolonged treatment with Tadekinig alfa in adult-onset Still’s disease
  1. Uta Kiltz1,
  2. David Kiefer1,
  3. Jürgen Braun1,
  4. Eduardo Jorge Schiffrin2,
  5. Charlotte Girard-Guyonvarc'h3,
  6. Cem Gabay3
  1. 1 Rheumazentrum Ruhrgebiet, Herne, Germany
  2. 2 AB2 Bio Ltd, Lausanne, Switzerland
  3. 3 Division of Rheumatology, Department of Internal Medicine Specialties, University of Geneva, Geneva, Switzerland
  1. Correspondence to Professor Cem Gabay, Division of Rheumatology,Department of Internal Medicine Specialties, University Hospitals of Geneva, Geneva 1211, Switzerland; cem.gabay{at}hcuge.ch

https://doi.org/10.1136/annrheumdis-2018-214496

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    Adult-onset Still’s disease (AOSD) is a rare systemic autoinflammatory disease, the treatment of which is still not well defined. Biological disease modifying antirheumatic drugs (bDMARDs), including interleukin (IL)-1 and IL-6 antagonists are used empirically in patients refractory to conventional DMARDs.1 This 12-week open-label clinical trial with Tadekinig (recombinant IL-18 binding protein, IL-18BP) showed promising results.2 Herein, we report two patients with AOSD treated successfully with Tadekinig during several months.

    Case 1. A 50-year-old patient was diagnosed with AOSD in August 2014 when presenting with arthritis, recurrent fever episodes, sore throat and skin rash. C reactive protein (CRP, 22.9 mg/dL) and ferritin (3568 ng/mL) levels were markedly elevated. Since the initial treatment with prednisolone starting with 100 mg/day and oral methotrexate (MTX) 15 mg/week was insufficient, anakinra was started with 100 mg sc/day and MTX dose was augmented to 25 mg sc/week. High disease activity persisted and prednisolone tapering below 15 mg/day was impossible. As a side effect …

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    Footnotes

    • Handling editor Josef S Smolen

    • Contributors All authors took part in drafting and revising the manuscript. CG-G performed the free IL-18 assays and drew figure 1. All authors approved the submitted version of the article.

    • Funding This study was funded by AB2 Bio.

    • Competing interests CG-G’s salary was supported by an unrestricted grant from AB2 Bio. EJS is an employee of AB2 Bio. CG has received consultant fees and a research grant from AB2 Bio and owns shares in AB2 Bio. All other authors have declared no conflicts of interest.

    • Patient consent Not required.

    • Ethics approval Geneva Ethics Committee on Research Involving Humans.

    • Provenance and peer review Not commissioned; internally peer reviewed.

    • Data sharing statement Should readers be interested in getting some additional unpublished data, they are asked to contact the authors.