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669954.pdf (278.61 KB)

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2015-09-01

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cc-by (c) Ortiz Sanjuán, Francisco et al., 2015
Si us plau utilitzeu sempre aquest identificador per citar o enllaçar aquest document: https://hdl.handle.net/2445/127430

Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review.

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https://doi.org/10.1097/MD.0000000000001554

Resum

Adult-onset Still's disease (AOSD) is often refractory to standard therapy. Anakinra (ANK), an interleukin-1 receptor antagonist, has demonstrated efficacy in single cases and small series of AOSD. We assessed the efficacy of ANK in a series of AOSD patients.Multicenter retrospective open-label study. ANK was used due to lack of efficacy to standard synthetic immunosuppressive drugs and in some cases also to at least 1 biologic agent.Forty-one patients (26women/15 men) were recruited. They had a mean age of 34.414 years and a median [interquartile range (IQR)] AOSD duration of 3.5 [2-6] years before ANK onset. At that time the most common clinical features were joint manifestations 87.8%, fever 78%, and cutaneous rash 58.5%. ANK yielded rapid and maintained clinical and laboratory improvement. After 1 year of therapy, the frequency of joint and cutaneous manifestations had decreased to 41.5% and to 7.3% respectively, fever from 78% to 14.6%, anemia from 56.1% to 9.8%, and lymphadenopathy from 26.8% to 4.9%. A dramatic improvement of laboratory parameters was also achieved. The median [IQR] prednisone dose was also reduced from 20 [11.3-47.5] mg/day at ANK onset to 5 [0-10] at 12 months. After a median [IQR] follow-up of 16 [5-50] months, the most important side effects were cutaneous manifestations (n=8), mild leukopenia (n=3), myopathy (n=1), and infections (n=5).ANK is associated with rapid and maintained clinical and laboratory improvement, even in nonresponders to other biologic agents. However, joint manifestations are more refractory than the systemic manifestations.

Matèries

Malalties rares, Reumatologia, Medicaments, Estudi de casos, Ús terapèutic

Matèries (anglès)

Rare diseases, Rheumatology, Drugs, Case studies, Therapeutic use

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Articles publicats en revistes (Ciències Clíniques)
Articles publicats en revistes (Institut d'lnvestigació Biomèdica de Bellvitge (IDIBELL))

Citació

ORTIZ SANJUÁN, Francisco, BLANCO, Ricardo, RIANCHO ZARRABEITIA, Leyre, CASTAÑEDA, Santos, OLIVÉ MARQUÉS, Alejandro, RIVEROS, Anne, VELLOSO FEIJOO, María l., NARVÁEZ GARCÍA, Francisco javier, JIMÉNEZ MOLEÓN, Inmaculada, MAIZ ALONSO, Olga, ORDÓÑEZ, María del carmen, BERNAL, José a., HERNÁNDEZ, María v., SIFUENTES GIRALDO, Walter a., GÓMEZ ARANGO, Catalina, GALÍNDEZ AGIRREGOIKOA, Eva, BLANCO MADRIGAL, Juan, ORTIZ SANTAMARIA, Vera, BLANCO BARNUSELL, Jordi del, DIOS, Juan r. de, MORENO, Mireia, FITER, Jordi, RISCOS, Marina de los, CARREIRA, Patricia, RODRIGUEZ VALLS, María j., GONZÁLEZ VELA, M. carmen, CALVO RÍO, Vanesa, LORICERA, Javier, PALMOU FONTANA, Natalia, PINA, Trinitario, LLORCA DÍAZ, Javier, GONZÁLEZ-GAY, Miguel a.. Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review.. _Medicine_. 2015. Vol. 94, núm. 39, pàgs. e1554. [consulta: 8 de gener de 2026]. ISSN: 0025-7974. [Disponible a: https://hdl.handle.net/2445/127430]

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