Emmi Giacomo, Talarico Rosaria, Lopalco Giuseppe, Cimaz Rolando, Cantini Fabrizio, Viapiana Ombretta, Olivieri Ignazio, Goldoni Matteo, Vitale Antonio, Silvestri Elena, Prisco Domenico, Lapadula Giovanni, Galeazzi Mauro, Iannone Florenzo, Cantarini Luca
Department of Experimental and Clinical Medicine, University of Florence, Florence, Italy.
Department of Clinical and Experimental Medicine, University of Pisa, Pisa, Italy.
Clin Rheumatol. 2016 May;35(5):1281-6. doi: 10.1007/s10067-015-3004-0. Epub 2015 Jul 10.
Growing data have provided encouraging results on the use of interleukin (IL)-1 inhibitors in Behçet's disease (BD). This study was aimed at reporting the largest experience with anti-IL-1 agents in BD patients. We evaluated 30 BD patients receiving treatment with anti-IL-1 agents. The primary aims of the study were to evaluate the efficacy of anakinra (ANA) and canakinumab (CAN) in a cohort of BD. The secondary aims were to evaluate the overall safety profile of the treatments, explore the timing of response to therapy and any adjustment of dosage and frequency of drugs studied, and investigate predictive factors of response to therapy. The frequency of first line therapy was 90 % with ANA and 10 % with CAN. The overall number of subjects in complete remission after 12 months of therapy with anti-IL-1 drugs was 13: 6 maintained the initial therapy regimen, 1 maintained the same initial anti-IL-1 drug with further therapeutic adjustments, and the remaining 6 shifted from ANA to CAN. Among them, 3 used CAN for at least 12 months without therapeutic adjustments, 1 had therapeutic adjustments, and 3 had an overall history of a 12-month complete remission. Adverse events (AEs) were reported in 15 % patients who received ANA, represented in all cases by local cutaneous reactions, while no AE were observed in patients who received CAN; we did not observe any serious AEs (SAEs) during the follow-up period. Our data have confirmed that the use of anti-IL-1β drugs is efficacious and safe with an overall acceptable retention on treatment.
越来越多的数据表明,白介素(IL)-1抑制剂在白塞病(BD)治疗中的应用取得了令人鼓舞的成果。本研究旨在报告BD患者使用抗IL-1药物的最大规模经验。我们评估了30例接受抗IL-1药物治疗的BD患者。本研究的主要目的是评估阿那白滞素(ANA)和卡那单抗(CAN)在BD队列中的疗效。次要目的是评估治疗的总体安全性,探讨治疗反应的时机以及所研究药物剂量和频率的任何调整,并研究治疗反应的预测因素。一线治疗的频率为ANA占90%,CAN占10%。使用抗IL-1药物治疗12个月后完全缓解的受试者总数为13例:6例维持初始治疗方案,1例维持相同的初始抗IL-1药物并进行了进一步的治疗调整,其余6例从ANA转为CAN。其中,3例使用CAN至少12个月且未进行治疗调整,1例进行了治疗调整,3例有12个月完全缓解的总体病史。接受ANA治疗的患者中有15%报告了不良事件(AE),所有病例均表现为局部皮肤反应,而接受CAN治疗的患者未观察到AE;在随访期间,我们未观察到任何严重不良事件(SAE)。我们的数据证实,使用抗IL-1β药物是有效且安全的,总体治疗保留率可接受。