Research Center of Systemic Autoinflammatory Diseases, Behçet's Disease and Rheumatology-Ophthalmology Collaborative Uveitis Center, Rheumatology Unit, Department of Medical Sciences, Surgery and Neurosciences, University of Siena, Siena, Italy.
Rheumatology Unit, Department of Emergency and Organ Transplantation, University of Bari, Bari, Italy.
Mediators Inflamm. 2020 Oct 15;2020:8054961. doi: 10.1155/2020/8054961. eCollection 2020.
Interleukin-1 inhibition has revealed to be a successful treatment approach for patients with adult-onset Still's disease (AOSD). However, real-life experience is focused on the use of anakinra, while data about canakinumab (CAN) are mainly based on case reports and small case series. . Patients classified with AOSD according to Yamaguchi criteria and treated with CAN were consecutively enrolled. Their clinical and therapeutic data were retrospectively collected and statistically analysed to assess the role of CAN as a therapeutic opportunity in AOSD patients in terms of clinical and laboratory disease control along with corticosteroid-sparing effect.
Nine AOSD patients (8 females and 1 male) treated with CAN for 15.00 ± 12.3 months were enrolled. Resolution of clinical manifestations was reported in 8/9 cases at the 3-month assessment; a significant decrease in the number of tender joints ( = 0.009), swollen joints ( = 0.027), and disease activity score on 28 joints-C-reactive protein (DAS28-CRP) ( = 0.044) was observed during the study period. The systemic score of disease activity significantly decreased at the 3-month and 6-month assessments and at the last visit compared to the start of treatment ( = 0.028, = 0.028, and = 0.018, respectively). The daily corticosteroid dosage was significantly reduced at the 3-month and at the last follow-up visits ( = 0.017 and = 0.018, respectively). None of the patients experienced adverse events or severe adverse events during the follow-up.
CAN has shown prompt and remarkable effectiveness in controlling AOSD activity in a real-life contest, with a significant glucocorticoid-sparing effect and an excellent safety profile.
白细胞介素-1 抑制已被证明是成人Still 病（AOSD）患者的有效治疗方法。然而，实际经验主要集中在使用阿那白滞素，而关于康那白介素（CAN）的数据主要基于病例报告和小病例系列。连续纳入了根据 Yamaguchi 标准诊断为 AOSD 并接受 CAN 治疗的患者。回顾性收集了他们的临床和治疗数据，并进行了统计学分析，以评估 CAN 作为 AOSD 患者治疗机会的作用，从临床和实验室疾病控制以及皮质类固醇节约效应两方面进行评估。
纳入了 9 名接受 CAN 治疗的 AOSD 患者（8 名女性和 1 名男性），治疗时间为 15.00±12.3 个月。在 3 个月评估时，8/9 例患者报告临床症状缓解；研究期间，观察到压痛关节数（=0.009）、肿胀关节数（=0.027）和 28 关节疾病活动度评分- C 反应蛋白（DAS28-CRP）（=0.044）显著减少。疾病活动的全身评分在 3 个月和 6 个月评估以及最后一次就诊时与治疗开始时相比显著降低（分别为=0.028、=0.028 和=0.018）。在 3 个月和最后一次随访时，每日皮质类固醇剂量显著减少（分别为=0.017 和=0.018）。在随访期间，没有患者发生不良反应或严重不良反应。
在真实环境中，CAN 迅速显著地控制了 AOSD 活动，具有显著的糖皮质激素节约作用和良好的安全性。
