Abstract
Interleukin-1β is one of the key cytokines mediating the development of clinical manifestations of systemic juvenile idiopathic arthritis (sJIA) in the early (febrile) and late phases of the disease. The implementation of interleukin-1β blockers into routine clinical practice has significantly changed the course of this severe disease. Objective. To assess the efficacy and safety of canakinumab in patients with sJIA. Patients and methods. This study included 73 sJIA patients who received canakinumab. Treatment was initiated in the Department of Rheumatology, National Medical Research Center for Children's Health (Moscow) between October 2012 and January 2020. The American College of Rheumatology (ACR) Pediatric criteria for assessing joint status (ACR Pedi 30, 50, 70, and 90) were used to evaluate treatment efficacy after one year of therapy. Inactive disease/remission was registered according to the С.Wallace criteria and the Juvenile Arthritis Disease Activity Score (JADAS71). Results. The majority of patients demonstrated an improvement after one year of therapy: 65 individuals (89%) according to ACR Pedi 30, 65 individuals (89%) according to ACR Pedi 50, 62 individuals (84,9%) according to ACR Pedi 70, and 61 individuals (83.6%) according to ACR Pedi 90. Inactive disease/remission according to JADAS71 and С.Wallace criteria was registered in 58 patients (79.45%). Conclusion. After one year of treatment, inactive disease/remission (С.Wallace and ACR Pedi 90 criteria) was achieved in 58 patients (79.45%) and 61 patients (83.6%), respectively. Long-term therapy with canakinumab was safe; the incidence of serious adverse events was 28.2 per 100 patient-years. Sustained remission without biologicals was observed in 7 out of 10 patients (13.7%), in whom there was an attempt to cease canakinumab. Key words: biologicals, interleukin-1β inhibitor, systemic juvenile idiopathic arthritis, inactive disease/remission, canakinumab, cytokines
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