TY - JOUR
T1 - Comparison of early vs. delayed anakinra treatment in patients with adult onset Still's disease and effect on clinical and laboratory outcomes
AU - Gremese, Elisa
AU - Rigante, Donato
AU - Manna, Raffaele
AU - Vitale, Antonio
AU - Cavalli, Giulio
AU - Ruscitti, Piero
AU - Sota, Jurgen
AU - Colafrancesco, Serena
AU - Priori, Roberta
AU - Valesini, Guido
AU - Argolini, Lorenza Maria
AU - Baldissera, Elena
AU - Bartoloni, Elena
AU - Cammelli, Daniele
AU - Cavallaro, Elena
AU - Cipriani, Paola
AU - De Marchi, Ginevra
AU - De Vita, Salvatore
AU - Emmi, Giacomo
AU - Frassi, Micol
AU - Gerli, Roberto
AU - Iannone, Florenzo
AU - Fornaro, Marco
AU - Paladini, Anna
AU - Lopalco, Giuseppe
AU - Mathieu, Alessandro
AU - Montecucco, Carlomaurizio
AU - Mosca, Marta
AU - Piazza, Ilaria
AU - Piga, Matteo
AU - Pontikaki, Irene
AU - Romano, Micol
AU - Rossi, Silvia
AU - Rossini, Maurizio
AU - Silvestri, Elena
AU - Stagnaro, Chiara
AU - Talarico, Rosaria
AU - Frediani, Bruno
AU - Tincani, Angela
AU - Viapiana, Ombretta
AU - Vitiello, Gianfranco
AU - Galozzi, Paola
AU - Sfriso, Paolo
AU - Gaggiano, Carla
AU - Grosso, Salvatore
AU - Dagna, Lorenzo
AU - Giacomelli, Roberto
AU - Cantarini, Luca
PY - 2020
Y1 - 2020
N2 - Background: Aim of this study was to search for any difference in the outcome of patients with adult onset Still's disease (AOSD) treated with anakinra (ANK) in relation with the interval between disease onset and the start of anti-interleukin(IL)-1 treatment and according with the different lines of ANK treatment. Patients and Methods: One hundred and forty-one AOSD patients treated with ANK have been retrospectively assessed. Statistically significant differences (p < 0.05) were analyzed in the frequency of ANK effectiveness, primary or secondary inefficacy to ANK and rate of resolution of clinical and laboratory AOSD manifestations after 3, 6, and 12 months since ANK treatment according with different lines of treatment and different times between AOSD onset and start of ANK. Results: No significant differences were identified in the ANK effectiveness and frequency of primary or secondary inefficacy for patients starting ANK within 6 months (p = 0.19, p = 0.14, and p = 0.81, respectively) or 12 months (p = 0.37, p = 0.23, and p = 0.81, respectively) since AOSD onset compared with patients starting ANK thereafter; no significant differences were identified in ANK effectiveness and primary or secondary inefficacy according with different lines of ANK treatment (p = 0.06, p = 0.19, and p = 0.13, respectively). Patients starting ANK within 6 and 12 months since AOSD onset showed a significantly quicker decrease of erythrocyte sedimentation rate and C-reactive protein than observed among patients undergoing ANK treatment after 6 and 12 months. The number of swollen joints at the 3 month follow-up visit was significantly lower among patients undergoing ANK within 6 months since AOSD onset (p = 0.01), while no significance was identified at the 6 and 12 month assessments (p = 0.23 and p = 0.45, respectively). At the 3 and 6 month visits, the number of swollen joints was significantly higher among patients previously treated with conventional and biological disease modifying anti-rheumatic drugs (DMARDs) compared with those formerly treated only with conventional DMARDs (p < 0.017). Conclusions: Clinical and therapeutic outcomes are substantially independent of how early ANK treatment is started in AOSD patients. However, a faster ANK effectiveness in controlling systemic inflammation and resolving articular manifestations may be observed in patients benefiting from IL-1 inhibition as soon as after disease onset.
AB - Background: Aim of this study was to search for any difference in the outcome of patients with adult onset Still's disease (AOSD) treated with anakinra (ANK) in relation with the interval between disease onset and the start of anti-interleukin(IL)-1 treatment and according with the different lines of ANK treatment. Patients and Methods: One hundred and forty-one AOSD patients treated with ANK have been retrospectively assessed. Statistically significant differences (p < 0.05) were analyzed in the frequency of ANK effectiveness, primary or secondary inefficacy to ANK and rate of resolution of clinical and laboratory AOSD manifestations after 3, 6, and 12 months since ANK treatment according with different lines of treatment and different times between AOSD onset and start of ANK. Results: No significant differences were identified in the ANK effectiveness and frequency of primary or secondary inefficacy for patients starting ANK within 6 months (p = 0.19, p = 0.14, and p = 0.81, respectively) or 12 months (p = 0.37, p = 0.23, and p = 0.81, respectively) since AOSD onset compared with patients starting ANK thereafter; no significant differences were identified in ANK effectiveness and primary or secondary inefficacy according with different lines of ANK treatment (p = 0.06, p = 0.19, and p = 0.13, respectively). Patients starting ANK within 6 and 12 months since AOSD onset showed a significantly quicker decrease of erythrocyte sedimentation rate and C-reactive protein than observed among patients undergoing ANK treatment after 6 and 12 months. The number of swollen joints at the 3 month follow-up visit was significantly lower among patients undergoing ANK within 6 months since AOSD onset (p = 0.01), while no significance was identified at the 6 and 12 month assessments (p = 0.23 and p = 0.45, respectively). At the 3 and 6 month visits, the number of swollen joints was significantly higher among patients previously treated with conventional and biological disease modifying anti-rheumatic drugs (DMARDs) compared with those formerly treated only with conventional DMARDs (p < 0.017). Conclusions: Clinical and therapeutic outcomes are substantially independent of how early ANK treatment is started in AOSD patients. However, a faster ANK effectiveness in controlling systemic inflammation and resolving articular manifestations may be observed in patients benefiting from IL-1 inhibition as soon as after disease onset.
KW - Anakinra
KW - Still's disease
KW - Anakinra
KW - Still's disease
UR - http://hdl.handle.net/10807/149491
U2 - 10.3389/fmed.2020.00042
DO - 10.3389/fmed.2020.00042
M3 - Article
VL - 2020
SP - 1
EP - 10
JO - Frontiers in Medicine
JF - Frontiers in Medicine
SN - 2296-858X
ER -