In a nutshell
This study investigated the long-term safety and effectiveness of canakinumab (Ilaris) in patients with systemic juvenile idiopathic arthritis (sJIA).
They found that this drug improved sJIA symptoms and was well tolerated in the long-term.
Some background
Systemic juvenile idiopathic arthritis (sJIA) is a condition that affects children under 16 years of age. It causes painful swelling and inflammation in the joints. To treat sJIA, patients are prescribed medication to reduce inflammation. Some medications block many substances in the body that cause inflammation. These include drugs like glucocorticoids (GCs) and non-steroidal anti-inflammatory drugs (NSAIDs). Some drugs used to treat sJIA have specific targets. These medications are called anti-rheumatic disease-modifying agents or DMARDs.
The cause of sJIA is unknown. Some studies suggest that a chemical called interleukin-1-beta (IL-1β) may play a role in the disease. IL-1β causes inflammation and blocking IL-1β may improve sJIA symptoms. Canakinumab (CKB) is a biological DMARD. It acts as an antibody and binds to IL-1β, blocking its effects. It has proven useful in treating sJIA. However, the long-term safety and effectiveness of CKB remain under investigation.
Methods & findings
This study included 144 patients with sJIA. Patients received CKB (4 mg/kg) every 4 weeks for the first phase of this study. For the second phase, patients received CKB (2 mg/kg) every 4 weeks. The first phase lasted 29.5 weeks and the second phase lasted a minimum of 96 weeks. Patients were evaluated every 3 months to measure disease activity, up to 5 years.
Patients showed a reduction in disease activity from 3 months. 49% of patients that completed the trial reached low disease activity after 2 years. 37.6% of patients also taking GCs were able to stop them or lower the dose of GCs.
Patients that were unable to stop taking GCs were less likely to respond well to CKB. Side effects of CKB included infections and sJIA flare-ups. Serious side effects were reported in 36.2% of patients.
The bottom line
The authors concluded that CKB improved sJIA symptoms and was well tolerated in the long-term.
The fine print
58% of patients stopped taking CKB at some point during the study. CKM may be more effective in certain sJIA cases and more investigation is needed.
What’s next?
If you have any concerns regarding sJIA treatment, please consult with your physician.
Published By :
Annals of the rheumatic diseases
Date :
Sep 29, 2018
