Discontinuation of Canakinumab following Clinical Disease Remission Is Feasible in Patients with Systemic Juvenile Idiopathic Arthritis

Maritsi, Despoina; Vougiouka, Olga; Eleftheriou, Despina

doi:10.3899/jrheum.190011

Cited by 6 publications

(3 citation statements)

References 8 publications

(7 reference statements)

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“…On the third day after administration, 100% of patients in the canakinumab treatment group, compared with 86.8% in the placebo group, had a normal body temperature (p = 0.0098) [38]. Shorter disease duration and lack of prior use of other biological DMARDs (bDMARDs) are associated with achieving long-term remission after canakinumab [39]. Achieving ACR improvement within 50 to 15 days of canakinumab, with the complete withdrawal of GCs, was a predictor of achieving long-term clinical remission [40].…”

Section: Il-1 Inhibitorsmentioning

confidence: 99%

“…Achieving ACR improvement within 50 to 15 days of canakinumab, with the complete withdrawal of GCs, was a predictor of achieving long-term clinical remission [40]. The good response to canakinumab has been shown to be associated with high counts of neutrophils and IL-1-related genes, as well as higher IL-18 to CXCL-9 and INFg to CXCL9 ratios at disease onset, whereas increased CD163 expres-sion was associated with a lack of response to the drug [39,41,42].…”

Section: Il-1 Inhibitorsmentioning

confidence: 99%

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Systemic juvenile idiopathic arthritis — current diagnostic and therapeutic management

2022

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Juvenile idiopathic arthritis (JIA) is a heterogeneous group of arthritis that has seven subtypes under the currently applicable ILAR classification. It is the most common arthropathy diagnosed in children, a chronic disease affecting children and adolescents. The systemic form of juvenile idiopathic arthritis (SJIA) is the most frequent subtype of the disease with a different aetiopathogenesis, broad clinical picture, various courses, burdened with numerous complications and requiring a therapeutic approach that is different than in other subtypes of JIA. In the case of SJIA, it is essential to establish the correct diagnosis as soon as possible and to initiate effective treatment and, if there is no effect after standard steroid therapy, use targeted anti-cytokine therapy. This review discusses current data on the aetiopathogenesis of the disease, clinical presentation and principles of diagnostic and therapeutic management.

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Section: Il-1 Inhibitorsmentioning

confidence: 99%

Section: Il-1 Inhibitorsmentioning

confidence: 99%

Systemic juvenile idiopathic arthritis — current diagnostic and therapeutic management

2022

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“…And oral corticosteroids (in a minimal dose and a short course) are conditionally recommended as an initial option of therapy. In the USA and Canada, based on the CARRA registry, 4 standardized treatment regimens for patients with sJIA were developed: (1) GCS only; (2) methotrexate with or without GCS; (3) IL-1 inhibitors with or without GCS; (4) IL-6 inhibitors with or without GCS (Nigrovic et al, 2018;Albaker, 2020;Maritsi et al, 2020).…”

Section: Introductionmentioning

confidence: 99%

Systemic juvenile idiopathic arthritis in the pediatric practice of Donetsk region

Koniushevska,

Vaiser,

Kuzevanova

et al. 2023

Regul. Mech. Biosyst.

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Juvenile idiopathic arthritis with systemic onset is a special, rare and the most severe variant of juvenile idiopathic arthritis. The article analyzes the clinical features of the onset and course of juvenile idiopathic arthritis with systemic onset in children living in the ecologically disadvantaged Donetsk region and the efficacy of therapy. Clinical cases are described. According to its clinical manifestations, the systemic variant of juvenile idiopathic arthritis is characterized by the severity of the general inflammatory response, a bright clinical picture, severe damage to internal organs, the development of polyserositis, can lead to the development of life-threatening conditions, such as macrophage activation syndrome, and also leads to the formation of deforming arthritis with early disability of the sick child. The relevance of studying the problem of juvenile idiopathic arthritis with a systemic onset is related to the late diagnosis of the disease, because at the onset of the disease there may be no joint syndrome, and therefore it is impossible to use the criteria of the International League of Rheumatology Associations to verify the diagnosis, which leads to diagnostic errors. Nonsteroidal anti-inflammatory drugs, glucocorticosteroids, and immunosuppressants are used for treatment. The prescription of genetic engineering biological therapy, the choice of the drug, is carried out according to the recommendations of the American College of Rheumatology, depending on the preference for systemic or joint manifestations of the disease. But the question of the optimal approach to regimens of dose reduction, duration of biological therapy, and rules for its withdrawal remains open. Until now, the optimal approach to the treatment of juvenile idiopathic arthritis with a systemic onset is unknown. To date, the issue of treatment in patients with pharmacoresistant variants and persistent course of the disease has not been solved. Therefore, further in-depth study of this problem, optimization of the diagnostic algorithm and an individual approach to therapy are needed.

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Juvenile Idiopathic Arthritis Treatment Updates

Onel

Rumsey

Shenoi

2021

Rheumatic Disease Clinics of North America

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Discontinuation of Canakinumab following Clinical Disease Remission Is Feasible in Patients with Systemic Juvenile Idiopathic Arthritis

Cited by 6 publications

References 8 publications

Systemic juvenile idiopathic arthritis — current diagnostic and therapeutic management

Systemic juvenile idiopathic arthritis — current diagnostic and therapeutic management

Systemic juvenile idiopathic arthritis in the pediatric practice of Donetsk region

Juvenile Idiopathic Arthritis Treatment Updates

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