Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response
Background: Anakinra (ANA) is an effective treatment choice in patients with adult onset Still’s disease (AOSD). Variables affecting treatment survival include loss of efficacy or adverse events, but also the decision to discontinue treatment after long-term clinical remission.Objectives: Aims of th...
| Main Authors: | , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , , |
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Frontiers Media S.A.
2019-04-01
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| Series: | Frontiers in Pharmacology |
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| Online Access: | https://www.frontiersin.org/article/10.3389/fphar.2019.00296/full |
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| author | Antonio Vitale Giulio Cavalli Giulio Cavalli Serena Colafrancesco Roberta Priori Guido Valesini Lorenza Maria Argolini Elena Baldissera Elena Bartoloni Daniele Cammelli Giovanni Canestrari Jurgen Sota Elena Cavallaro Maria Grazia Massaro Piero Ruscitti Paola Cipriani Ginevra De Marchi Salvatore De Vita Giacomo Emmi Gianfranco Ferraccioli Micol Frassi Roberto Gerli Elisa Gremese Florenzo Iannone Giovanni Lapadula Giuseppe Lopalco Raffaele Manna Alessandro Mathieu Carlomaurizio Montecucco Marta Mosca Ilaria Piazza Matteo Piga Irene Pontikaki Micol Romano Silvia Rossi Maurizio Rossini Elena Silvestri Chiara Stagnaro Rosaria Talarico Angela Tincani Ombretta Viapiana Gianfranco Vitiello Paola Galozzi Paolo Sfriso Carla Gaggiano Donato Rigante Lorenzo Dagna Lorenzo Dagna Roberto Giacomelli Luca Cantarini |
| author_facet | Antonio Vitale Giulio Cavalli Giulio Cavalli Serena Colafrancesco Roberta Priori Guido Valesini Lorenza Maria Argolini Elena Baldissera Elena Bartoloni Daniele Cammelli Giovanni Canestrari Jurgen Sota Elena Cavallaro Maria Grazia Massaro Piero Ruscitti Paola Cipriani Ginevra De Marchi Salvatore De Vita Giacomo Emmi Gianfranco Ferraccioli Micol Frassi Roberto Gerli Elisa Gremese Florenzo Iannone Giovanni Lapadula Giuseppe Lopalco Raffaele Manna Alessandro Mathieu Carlomaurizio Montecucco Marta Mosca Ilaria Piazza Matteo Piga Irene Pontikaki Micol Romano Silvia Rossi Maurizio Rossini Elena Silvestri Chiara Stagnaro Rosaria Talarico Angela Tincani Ombretta Viapiana Gianfranco Vitiello Paola Galozzi Paolo Sfriso Carla Gaggiano Donato Rigante Lorenzo Dagna Lorenzo Dagna Roberto Giacomelli Luca Cantarini |
| author_sort | Antonio Vitale |
| collection | DOAJ |
| description | Background: Anakinra (ANA) is an effective treatment choice in patients with adult onset Still’s disease (AOSD). Variables affecting treatment survival include loss of efficacy or adverse events, but also the decision to discontinue treatment after long-term clinical remission.Objectives: Aims of this study were: (i) to assess the drug retention rate (DRR) of ANA during a long-term follow-up looking for any difference related to the line of biologic treatment, the concomitant use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and the different type of AOSD (systemic versus chronic articular); (ii) to identify predictive factors of lack of efficacy, loss of efficacy, and ANA withdrawal owing to long-term remission.Methods: AOSD patients classified according with Yamaguchi criteria and treated with ANA were retrospectively enrolled in 18 Italian tertiary Centers. Demographic, laboratory, clinical and therapeutic data related to the start of ANA (baseline), the 3-month assessment and the last follow-up visit while on ANA treatment were retrospectively collected and statistically analyzed.Results: One hundred and forty-one AOSD patients (48 males, 93 females) treated with ANA for a mean period of 35.96 ± 36.05 months were enrolled. The overall DRR of ANA was 44.6 and 30.5% at the 60- and 120-month assessments, respectively, with no significant differences between: (i) biologic naïve patients and those previously treated with other biologics (log-rank p = 0.97); (ii) monotherapy and concomitant use of cDMARDs (log-rank p = 0.45); (iii) systemic and chronic articular types of AOSD (log-rank p = 0.67). No variables collected at baseline could predict primary inefficacy, while the number of swollen joints at baseline was significantly associated with secondary inefficacy (p = 0.01, OR = 1.194, C.I. 1.043–1.367). The typical AOSD skin rash was negatively related with ANA withdrawal owing to long-term remission (p = 0.03, OR = 0.224, C.I. 0.058–0.863).Conclusion: Long-term DRR of ANA has been found excellent and is not affected by different lines of biologic treatment, concomitant use of cDMARDs, or type of AOSD. The risk of losing ANA efficacy increases along with the number of swollen joints at the start of therapy, while the typical skin rash is a negative predictor of ANA withdrawal related to sustained remission. |
| first_indexed | 2024-12-11T01:03:45Z |
| format | Article |
| id | doaj.art-5f840fe673074997878f6a7e7014af2a |
| institution | Directory Open Access Journal |
| issn | 1663-9812 |
| language | English |
| last_indexed | 2024-12-11T01:03:45Z |
| publishDate | 2019-04-01 |
| publisher | Frontiers Media S.A. |
| record_format | Article |
| series | Frontiers in Pharmacology |
| spelling | doaj.art-5f840fe673074997878f6a7e7014af2a2022-12-22T01:26:15ZengFrontiers Media S.A.Frontiers in Pharmacology1663-98122019-04-011010.3389/fphar.2019.00296438712Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment ResponseAntonio Vitale0Giulio Cavalli1Giulio Cavalli2Serena Colafrancesco3Roberta Priori4Guido Valesini5Lorenza Maria Argolini6Elena Baldissera7Elena Bartoloni8Daniele Cammelli9Giovanni Canestrari10Jurgen Sota11Elena Cavallaro12Maria Grazia Massaro13Piero Ruscitti14Paola Cipriani15Ginevra De Marchi16Salvatore De Vita17Giacomo Emmi18Gianfranco Ferraccioli19Micol Frassi20Roberto Gerli21Elisa Gremese22Florenzo Iannone23Giovanni Lapadula24Giuseppe Lopalco25Raffaele Manna26Alessandro Mathieu27Carlomaurizio Montecucco28Marta Mosca29Ilaria Piazza30Matteo Piga31Irene Pontikaki32Micol Romano33Silvia Rossi34Maurizio Rossini35Elena Silvestri36Chiara Stagnaro37Rosaria Talarico38Angela Tincani39Ombretta Viapiana40Gianfranco Vitiello41Paola Galozzi42Paolo Sfriso43Carla Gaggiano44Donato Rigante45Lorenzo Dagna46Lorenzo Dagna47Roberto Giacomelli48Luca Cantarini49Research Centre of Systemic Autoinflammatory Diseases, Behçet’s Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, ItalyVita-Salute San Raffaele University, Milan, ItalyUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, ItalyRheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, ItalyRheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, ItalyRheumatology Unit, Department of Internal Medicine and Medical Specialties, Sapienza University of Rome, Rome, ItalyDivision of Rheumatology, ASST Gaetano Pini, Milan, ItalyUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, ItalyRheumatology Unit, Department of Medicine, University of Perugia, Perugia, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, Firenze, ItalyInstitute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, ItalyResearch Centre of Systemic Autoinflammatory Diseases, Behçet’s Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, ItalyDepartment of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, Italy0Periodic Fever Research Center, Institute of Internal Medicine, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy1Department of Biotechnological and Applied Clinical Science, Division of Rheumatology, University of L’Aquila, L’Aquila, Italy1Department of Biotechnological and Applied Clinical Science, Division of Rheumatology, University of L’Aquila, L’Aquila, ItalyDepartment of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, ItalyDepartment of Medical and Biological Sciences, Rheumatology Clinic, University of Udine, Udine, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, Firenze, ItalyInstitute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy2Rheumatology and Clinical Immunology, Spedali Civili and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, ItalyRheumatology Unit, Department of Medicine, University of Perugia, Perugia, ItalyInstitute of Rheumatology and Affine Sciences, Division of Rheumatology, Catholic University of the Sacred Heart, Rome, Italy3Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy3Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy3Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy0Periodic Fever Research Center, Institute of Internal Medicine, Catholic University of the Sacred Heart, Fondazione Policlinico A. Gemelli, Rome, Italy4Rheumatology Unit, Department of Medical Sciences, University and AOU of Cagliari, Cagliari, Italy5Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy6Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy7Rheumatology Unit, Department of Medicine, University of Verona, Verona, Italy4Rheumatology Unit, Department of Medical Sciences, University and AOU of Cagliari, Cagliari, ItalyDivision of Rheumatology, ASST Gaetano Pini, Milan, ItalyDivision of Rheumatology, ASST Gaetano Pini, Milan, Italy5Department of Rheumatology, IRCCS Policlinico San Matteo Foundation, University of Pavia, Pavia, Italy7Rheumatology Unit, Department of Medicine, University of Verona, Verona, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy6Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy6Rheumatology Unit, Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy2Rheumatology and Clinical Immunology, Spedali Civili and Department of Clinical and Experimental Sciences, University of Brescia, Brescia, Italy7Rheumatology Unit, Department of Medicine, University of Verona, Verona, ItalyDepartment of Experimental and Clinical Medicine, University of Firenze, Firenze, Italy8Department of Medicine DIMED, Rheumatology Unit, University of Padua, Padua, Italy8Department of Medicine DIMED, Rheumatology Unit, University of Padua, Padua, Italy9Clinical Pediatrics, Department of Molecular Medicine and Development, University of Siena, Siena, Italy0Institute of Pediatrics, Università Cattolica Sacro Cuore, Fondazione Policlinico Universitario A. Gemelli I.R.C.C.S., Rome, ItalyVita-Salute San Raffaele University, Milan, ItalyUnit of Immunology, Rheumatology, Allergy and Rare Diseases (UnIRAR), IRCCS San Raffaele Scientific Institute, Milan, Italy1Department of Biotechnological and Applied Clinical Science, Division of Rheumatology, University of L’Aquila, L’Aquila, ItalyResearch Centre of Systemic Autoinflammatory Diseases, Behçet’s Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis Centre, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, ItalyBackground: Anakinra (ANA) is an effective treatment choice in patients with adult onset Still’s disease (AOSD). Variables affecting treatment survival include loss of efficacy or adverse events, but also the decision to discontinue treatment after long-term clinical remission.Objectives: Aims of this study were: (i) to assess the drug retention rate (DRR) of ANA during a long-term follow-up looking for any difference related to the line of biologic treatment, the concomitant use of conventional disease modifying anti-rheumatic drugs (cDMARDs) and the different type of AOSD (systemic versus chronic articular); (ii) to identify predictive factors of lack of efficacy, loss of efficacy, and ANA withdrawal owing to long-term remission.Methods: AOSD patients classified according with Yamaguchi criteria and treated with ANA were retrospectively enrolled in 18 Italian tertiary Centers. Demographic, laboratory, clinical and therapeutic data related to the start of ANA (baseline), the 3-month assessment and the last follow-up visit while on ANA treatment were retrospectively collected and statistically analyzed.Results: One hundred and forty-one AOSD patients (48 males, 93 females) treated with ANA for a mean period of 35.96 ± 36.05 months were enrolled. The overall DRR of ANA was 44.6 and 30.5% at the 60- and 120-month assessments, respectively, with no significant differences between: (i) biologic naïve patients and those previously treated with other biologics (log-rank p = 0.97); (ii) monotherapy and concomitant use of cDMARDs (log-rank p = 0.45); (iii) systemic and chronic articular types of AOSD (log-rank p = 0.67). No variables collected at baseline could predict primary inefficacy, while the number of swollen joints at baseline was significantly associated with secondary inefficacy (p = 0.01, OR = 1.194, C.I. 1.043–1.367). The typical AOSD skin rash was negatively related with ANA withdrawal owing to long-term remission (p = 0.03, OR = 0.224, C.I. 0.058–0.863).Conclusion: Long-term DRR of ANA has been found excellent and is not affected by different lines of biologic treatment, concomitant use of cDMARDs, or type of AOSD. The risk of losing ANA efficacy increases along with the number of swollen joints at the start of therapy, while the typical skin rash is a negative predictor of ANA withdrawal related to sustained remission.https://www.frontiersin.org/article/10.3389/fphar.2019.00296/fullautoinflammatory diseasessystemic onset juvenile idiopathic arthritispersonalized medicinecanakinumabinnovative biotechnologiesinterleukin-1 |
| spellingShingle | Antonio Vitale Giulio Cavalli Giulio Cavalli Serena Colafrancesco Roberta Priori Guido Valesini Lorenza Maria Argolini Elena Baldissera Elena Bartoloni Daniele Cammelli Giovanni Canestrari Jurgen Sota Elena Cavallaro Maria Grazia Massaro Piero Ruscitti Paola Cipriani Ginevra De Marchi Salvatore De Vita Giacomo Emmi Gianfranco Ferraccioli Micol Frassi Roberto Gerli Elisa Gremese Florenzo Iannone Giovanni Lapadula Giuseppe Lopalco Raffaele Manna Alessandro Mathieu Carlomaurizio Montecucco Marta Mosca Ilaria Piazza Matteo Piga Irene Pontikaki Micol Romano Silvia Rossi Maurizio Rossini Elena Silvestri Chiara Stagnaro Rosaria Talarico Angela Tincani Ombretta Viapiana Gianfranco Vitiello Paola Galozzi Paolo Sfriso Carla Gaggiano Donato Rigante Lorenzo Dagna Lorenzo Dagna Roberto Giacomelli Luca Cantarini Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response Frontiers in Pharmacology autoinflammatory diseases systemic onset juvenile idiopathic arthritis personalized medicine canakinumab innovative biotechnologies interleukin-1 |
| title | Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response |
| title_full | Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response |
| title_fullStr | Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response |
| title_full_unstemmed | Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response |
| title_short | Long-Term Retention Rate of Anakinra in Adult Onset Still’s Disease and Predictive Factors for Treatment Response |
| title_sort | long term retention rate of anakinra in adult onset still s disease and predictive factors for treatment response |
| topic | autoinflammatory diseases systemic onset juvenile idiopathic arthritis personalized medicine canakinumab innovative biotechnologies interleukin-1 |
| url | https://www.frontiersin.org/article/10.3389/fphar.2019.00296/full |
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