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Beneficial Effect of Interleukin 1 Inhibition with Anakinra in Adult-onset Still’s Disease. An Open, Randomized, Multicenter Study

2012; The Journal of Rheumatology Publishing Company Limited; Volume: 39; Issue: 10 Linguagem: Inglês

10.3899/jrheum.111549

1499-2752

Dan Nordström, Ann Knight, Reijo Luukkainen, Ronald van Vollenhoven, Vappu Rantalaiho, ANNA KAJALAINEN, Johan G. Brun, Anne Prøven, Lotta Ljung, Hannu Kautiainen, Tom Pettersson,

Family and Disability Support Research

Objective. To study the efficacy of anakinra versus disease-modifying antirheumatic drugs (DMARD) in refractory adult-onset Still’s disease (AOSD). Methods. In a 24-week study, 22 patients with AOSD taking prednisolone ≥ 10 mg/day received anakinra (n = 12) or DMARD (n = 10). The primary endpoint was achievement of remission. Results. At 8 and 24 weeks, 7/12 and 6/12 receiving anakinra and 5/10 and 2/10 receiving DMARD achieved remission. Anakinra induced greater improvement in physical health measured by Medical Outcomes Study Short-Form 36 (SF-36; p < 0.011). During an open-label extension (OLE) of 28 weeks, 7/14 patients taking anakinra and 2/3 taking DMARD were in remission. Conclusion. Anakinra induced more beneficial responses than DMARD in patients with AOSD and was favored in the OLE phase. ( ClinicalTrials.gov Protocol Registration NCT01033656 ).