Please use this identifier to cite or link to this item:
Title: Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review.
Authors: Ortiz-Sanjuán, Francisco
Blanco, Ricardo
Riancho-Zarrabeitia, Leyre
Castañeda, Santos
Olivé, Alejandro
Riveros, Anne
Velloso-Feijoo, María L
Narváez, Javier
Jiménez-Moleón, Inmaculada
Maiz-Alonso, Olga
Ordóñez, Carmen
Bernal, José A
Hernández, María V
Sifuentes-Giraldo, Walter A
Gómez-Arango, Catalina
Galíndez-Agirregoikoa, Eva
Blanco-Madrigal, Juan
Ortiz-Santamaria, Vera
del Blanco-Barnusell, Jordi
De Dios, Juan R
Moreno, Mireia
Fiter, Jordi
de los Riscos, Marina
Carreira, Patricia
Rodriguez-Valls, María J
González-Vela, M Carmen
Calvo-Río, Vanesa
Loricera, Javier
Palmou-Fontana, Natalia
Pina, Trinitario
Llorca, Javier
González-Gay, Miguel A
metadata.dc.contributor.authoraffiliation: [Ortiz-Sanjuán,F; Blanco,R; Riancho-Zarrabeitia,L; González-Vela,MC; Calvo-Río,V; Loricera,J; Palmou-Fontana,N; Pina,T; González-Gay,MA] Hospital Universitario Marqués de Valdecilla, IDIVAL, Santander. [Castañeda,S] Hospital Universitario de La Princesa, IIS Princesa Madrid, Madrid. [Olivé,A; Riveros,A] Hospital Universitario Germans Trias i Pujol, Badalona. [Velloso-Feijoo,ML] Hospital Valme, Sevilla. [Narváez,J] Hospital Universitario de Bellvitge Hospitalet, Barcelona. [Jiménez-Moleón,I] Hospital San Cecilio, Granada. [Maiz-Alonso,O] HU Donostia, San Sebastián. [Ordóñez,C] HRU Carlos Haya, Málaga. [Bernal,JA] HGU, Alicante, Alicante. [Hernández,MV] Hospital Clinic of Barcelona, Barcelona. [Sifuentes-Giraldo,WA] Hospital Ramón y Cajal, Madrid. [Gómez-Arango,C; Galíndez-Agirregoikoa,E; Blanco-Madrigal,J] Hospital Universitario Basurto, Bilbao. [Ortiz-Santamaria,V] Hospital General Granollers, Granollers, Spain. [del Blanco-Barnusell,J] H Sant Jaume, Calella. [De Dios,JD] HU Álava, Vitoria. [Moreno,M] HU Parc Taulí, Sabadell. [Fiter,J] HU Son Espases, Palma de Mallorca, Mallorca. [de los Riscos,M; Carreira,P] Hospital Universitario 12 de Octubre, Madrid. [Rodriguez-Valls,MJ] Hospital de Jerez, Jerez. [Llorca,JL] Universidad de Cantabria, IDIVAL, Santander. CIBER Epidemiology and Public Health (CIBERESP), Santander Spain.
Keywords: Adulto;Quimioterapia combinada;Femenino;Humanos;Inmunosupresores;Proteína antagonista del receptor de interleucina 1;Masculino;Mediana edad;Prednisona;Estudios retrospectivos;Enfermedad de Still del adulto
metadata.dc.subject.mesh: Medical Subject Headings::Persons::Persons::Age Groups::Adult
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Therapeutics::Drug Therapy::Drug Therapy, Combination
Medical Subject Headings::Check Tags::Female
Medical Subject Headings::Organisms::Eukaryota::Animals::Chordata::Vertebrates::Mammals::Primates::Haplorhini::Catarrhini::Hominidae::Humans
Medical Subject Headings::Chemicals and Drugs::Chemical Actions and Uses::Pharmacologic Actions::Physiological Effects of Drugs::Immunologic Factors::Immunosuppressive Agents
Medical Subject Headings::Chemicals and Drugs::Amino Acids, Peptides, and Proteins::Peptides::Intercellular Signaling Peptides and Proteins::Cytokines::Interleukin 1 Receptor Antagonist Protein
Medical Subject Headings::Check Tags::Male
Medical Subject Headings::Persons::Persons::Age Groups::Adult::Middle Aged
Medical Subject Headings::Chemicals and Drugs::Polycyclic Compounds::Steroids::Pregnanes::Pregnadienes::Pregnadienediols::Prednisone
Medical Subject Headings::Analytical, Diagnostic and Therapeutic Techniques and Equipment::Investigative Techniques::Epidemiologic Methods::Epidemiologic Study Characteristics as Topic::Epidemiologic Studies::Case-Control Studies::Retrospective Studies
Medical Subject Headings::Diseases::Immune System Diseases::Autoimmune Diseases::Arthritis, Rheumatoid::Still's Disease, Adult-Onset
Issue Date: Sep-2015
Publisher: Lippincott, Williams & Wilkins
Citation: Ortiz-Sanjuán F, Blanco R, Riancho-Zarrabeitia L, Castañeda S, Olivé A, Riveros A, et al. Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review. Medicine (Baltimore). 2015 ; 94(39):e1554
Abstract: Adult-onset Still's disease (AOSD) is often refractory to standard therapy. Anakinra (ANK), an interleukin-1 receptor antagonist, has demonstrated efficacy in single cases and small series of AOSD. We assessed the efficacy of ANK in a series of AOSD patients. Multicenter retrospective open-label study. ANK was used due to lack of efficacy to standard synthetic immunosuppressive drugs and in some cases also to at least 1 biologic agent. Forty-one patients (26 women/15 men) were recruited. They had a mean age of 34.4 ± 14 years and a median [interquartile range (IQR)] AOSD duration of 3.5 [2-6] years before ANK onset. At that time the most common clinical features were joint manifestations 87.8%, fever 78%, and cutaneous rash 58.5%. ANK yielded rapid and maintained clinical and laboratory improvement. After 1 year of therapy, the frequency of joint and cutaneous manifestations had decreased to 41.5% and to 7.3% respectively, fever from 78% to 14.6%, anemia from 56.1% to 9.8%, and lymphadenopathy from 26.8% to 4.9%. A dramatic improvement of laboratory parameters was also achieved. The median [IQR] prednisone dose was also reduced from 20 [11.3-47.5] mg/day at ANK onset to 5 [0-10] at 12 months. After a median [IQR] follow-up of 16 [5-50] months, the most important side effects were cutaneous manifestations (n = 8), mild leukopenia (n = 3), myopathy (n = 1), and infections (n = 5). ANK is associated with rapid and maintained clinical and laboratory improvement, even in nonresponders to other biologic agents. However, joint manifestations are more refractory than the systemic manifestations.
metadata.dc.identifier.doi: 10.1097/MD.0000000000001554
ISSN: 1536-5964 (Online)
0025-7974 (Print)
Appears in Collections:01- Artículos - AGS Sur de Sevilla
01- Artículos - Complejo Hospitalario Universitario de Granada
01- Artículos - Hospital de Jerez
01- Artículos - Hospital Regional de Málaga

Files in This Item:
File Description SizeFormat 
OrtizSanjuan_EfficacyOfAnakinra.pdfArtículo publicado278,61 kBAdobe PDFView/Open

This item is protected by original copyright

This item is licensed under a Creative Commons License Creative Commons