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Impressive Survival of Interleukin-1 Inhibitors in Systemic Juvenile Idiopathic Arthritis

Jack Cush, MD

The drug retention rate of interleukin-1 inhibitors (IL-1) used to treat systemic juvenile idiopathic arthritis (JIA) appears to be quite high according to a new study. 

Investigators performed a retrospective cohort review of 77 sJIA patients enrolled from 15 Italian centers who were treated with either anakinra (ANA) and canakinumab (CAN). The mean age of these patients was 12.7 years and mean sJIA disease duration was 4 years.

The retention rate of these IL-1 inhibitors at 12-, 24-, 48-, and 60-months of follow-up was 79.9%, 59.5%, 53.%5, and 53.5%, respectively.

While the differences were not statistically different between ANA and CAN, the cumulative survival (retention) trended in favor of CAN, without concomitant DMARD (p = 0.056) and with concomitant DMARD use (p = 0.058).  Survival was significantly better with first time use of an IL-1 inhibitor.

Adverse events were significantly more frequent in those previously treated with biologic drugs (p = 0.038) compared to biologic naive patients.

Those with a higher risk of IL-1 inhibitors withdrawal included patients previously treated with other biologics (HR = 3.357 [CI: 1.341-8.406], p = 0.01) and those experiencing AEs (HR = 2.970 [CI: 1.186-7.435], p = 0.020).

These data suggest an excellent overall for both ANA and CAN, especially when used first line to manage sJIA.


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