PT  - JOURNAL ARTICLE
AU  - Benedetta Saccomanno
AU  - Jessica Tibaldi
AU  - Francesca Minoia
AU  - Francesca Bagnasco
AU  - Angela Pistorio
AU  - Andressa Guariento
AU  - Roberta Caorsi
AU  - Alessandro Consolaro
AU  - Marco Gattorno
AU  - Angelo Ravelli
TI  - Predictors of Effectiveness of Anakinra in Systemic Juvenile Idiopathic Arthritis
AID  - 10.3899/jrheum.180331
DP  - 2019 Jan 15
TA  - The Journal of Rheumatology
PG  - jrheum.180331
4099  - http://www.jrheum.org/content/early/2019/01/11/jrheum.180331.short
4100  - http://www.jrheum.org/content/early/2019/01/11/jrheum.180331.full
AB  - Objective To seek predictors of therapeutic response to the interleukin (IL)-1 inhibitor anakinra in children with systemic-onset juvenile idiopathic arthritis (sJIA). Methods The clinical charts of all patients with sJIA who were newly treated with anakinra at our center between 2004 and 2017 were reviewed retrospectively. Predictors included baseline demographic, clinical, and laboratory variables as well as previous or concomitant therapies. The effectiveness of anakinra was assessed at 1 year after treatment start. Complete clinical response (CCR) was defined as absence of fever, physician’s global assessment ≤ 1, count of active joints ≤ 1, negative C-reactive protein, and ≥ 75% reduction of corticosteroid dose. According to the intention-to-treat principle, patients who had anakinra discontinued before 1 year for any reasons other than disease remission were classified as nonresponders. Statistics included univariate and multivariable analyses. Results Of the 62 patients included in the study, 24 (39%) met the criteria for CCR at 1 year, whereas 38 (61%) did not. On multivariable analysis, independent correlations with achievement of CCR were identified for shorter disease duration, lower active joint count, higher ferritin level, and greater activity of systemic manifestations. The area under the curve of the model was 0.83. Conclusion Our findings help to delineate the clinical profile of patients with sJIA who are more likely to benefit from IL-1 blockade. They also underscore the need for studies aimed at examining the therapeutic role of early IL-1 inhibition and to identify biomarkers predicting response to either IL-1 or IL-6 antagonists.