Early versus late treatment strategy with IL-1 inhibitors and IL-6 inhibitors
| Intervention | First author | Study design | Patients (N) | Concomitant treatment | Time from disease onset to treatment start in months (IQR) | Time of assessment | CID (%) | Other outcomes | |
| Early treatment | IL-1 inhibitors | Nigrovic48 | LOR | sJIA (46) | DMARDs, GCs and DMARDs+GCs | 2.8 (1.5–4.8) | M1 | 27 (59%)* | na |
| Kimura70 | LOP | sJIA (12) | GCs | 1 (median) | M9 | 5 (42%) | na | ||
| ter Haar73 | LOP | sJIA (42) | GCs | 1 (0.6–2) | M1, M3 and M12 | 23 (55%) 35 (83%) 32 (76%) | na | ||
| IL-6 inhibitors | Kimura70 | LOP | sJIA (10) | GCs | 1.8 (median) | M9 | 6 (60%) | na | |
| Roszkiewicz98 | LOR | sJIA (10) | GCs, MTX and CsA | 5.5 (median) | M3 | 10 (100%) | na | ||
| Comparison of early versus late treatment | IL-1 inhibitors | Pardeo68 | LOR | sJIA (56) | DMARDs and GCs | Early <3 | M6 | 35/37 (92%) | na |
| Late ≥3 | M6 | 7/19 (37%) | |||||||
| Horneff71 | LOR | sJIA (20) | GCs | Early <12 | M24† | na | JADAS<1 (80%) | ||
| sJIA (37) | GCs | Late ≥12 | M24 | na | JADAS<1 (38%) | ||||
| IL-6 inhibitors | Horneff71 | LOR | sJIA (24) | GCs | Early <12 | M24 | na | JADAS<1 (75%) | |
| sJIA (47) | GCs | Late ≥12 | M24 | na | JADAS<1 (44%) | ||||
| Pacharapakornpong97 | LOR | sJIA (43) | GCs and DMARDs | Early 1 (4) | M12 | 6/11 (54%) | ACR70 (94%) | ||
| Late 7.5 (23) | 0/12 | ACR70 (50%) | |||||||
| Late treatment | IL-1 inhibitors | Quartier45 | RCT and LTE | sJIA (22) | 0 | 4.2 (3.33 SD) years minimum 6M | M12 | 5 (16%) | na |
| Ruperto52 | RCT and LTE | sJIA (177) | GCs, MTX and NSAIDs | 2.1 (0.8–4.3) years minimum 2M | M7 | 55 (31%) | na | ||
| De Benedetti24 | RCT and LTE | sJIA (112) | GCs and MTX | 5.2±4 years minimum 6M | M12 | 36 (32%) | na |
*In this study, the response was defined as complete if no or minimal residual symptoms, with no requirement for supplemental agents to maintain clinical remission and normal laboratory findings.
†Estimated as last time observation.
ACR, American College of Rheumatology; ANK, anakinra; CID, clinical inactive disease; DMARDs, disease-modifying antirheumatic drugs; GC, glucocorticoids; IL, interleukin; JADAS, juvenile arthritis disease activity score; LOP, longitudinal observational prospective; LOR, longitudinal observational retrospective; LTE, long-term extension; MTX, methotrexate; na, not available; NSAIDs, non-steroidal anti-inflammatory drugs; RCT, randomised controlled trial; sJIA, systemic juvenile idiopathic arthritis.