Drug survival of anakinra and canakinumab in monogenic autoinflammatory diseases: observational study from the International AIDA Registry

Donato Rigante, Elena Verrecchia, Raffaele Manna, Ludovico Luca Sicignano, J Sota, R Cimaz, M Cattalini, M Frassi, E Aragona, MC Maggio, G Lopalco, G Emmi, P Parronchi, A Cauli, E Wiesik-Szewczyk, J Hernández-Rodríguez, C Gaggiano, M Tarsia, M Mourabi, G RagabA Vitale, C Fabiani, B Frediani, V Lamacchia, A Renieri, L Cantarini

Risultato della ricerca: Contributo in rivistaArticolo in rivista

Abstract

Objectives: To investigate survival of interleukin (IL)-1 inhibitors in monogenic autoinflammatory disorders (mAID) through drug retention rate (DRR) and identify potential predictive factors of drug survival from a real-life perspective. Patients and methods: Multicentre retrospective study analyzing patients affected by the most common mAID treated with anakinra or canakinumab. Survival curves were analyzed with the Kaplan-Meier method. Statistical analysis included a Cox-proportional hazard model to detect factors responsible for drug discontinuation. Results: Seventy-eight patients for a total of 102 treatment regimens were enrolled. The mean treatment duration was 29.59 months. The estimated DRR of IL-1 inhibitors at 12, 24, and 48 months of follow-up was 75.8%, 69.7% and 51.1%, respectively. Patients experiencing an adverse event had a significantly lower DRR (p = 0.019). In contrast, no significant differences were observed between biologic-naïve patients and those previously treated with biologic drugs (p = 0.985) Patients carrying high-penetrance mutations exhibited a significantly higher DRR compared with those with low-penetrance variants (p = 0.015). Adverse events were the only variable associated with a higher hazard of treatment withdrawal (HR 2.573 [CI: 1.223-5.411], p = 0.013) on regression analysis. A significant glucorticoid-sparing effect was observed (p < 0.0001). Conclusions: IL-1 inhibitors display an excellent long-term effectiveness in terms of DRR, and their survival is not influenced by the biologic line of treatment. They display a favorable safety profile, that deserves however a close monitoring given its impact on treatment continuation. Special attention should be paid to molecular diagnosis and mutation penetrance, as patients carrying low-penetrance variants are more likely to interrupt treatment.
Lingua originaleEnglish
pagine (da-a)5705-5712
Numero di pagine8
RivistaRheumatology
Volume2021
DOI
Stato di pubblicazionePubblicato - 2021

Keywords

  • Anakinra
  • Autoinflammation

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