Short-term outcomes in patients with systemic juvenile idiopathic arthritis treated with either tocilizumab or anakinra
Identifieur interne : 001198 ( Main/Exploration ); précédent : 001197; suivant : 001199Short-term outcomes in patients with systemic juvenile idiopathic arthritis treated with either tocilizumab or anakinra
Auteurs : Lianne Kearsley-Fleet [Royaume-Uni] ; Michael W. Beresford [Royaume-Uni] ; Rebecca Davies [Royaume-Uni] ; Diederik De Cock [Royaume-Uni] ; Eileen Baildam [Royaume-Uni] ; Helen E. Foster [Royaume-Uni] ; Taunton R. Southwood [Royaume-Uni] ; Wendy Thomson [Royaume-Uni] ; Kimme L. Hyrich [Royaume-Uni]Source :
- Rheumatology (Oxford, England) [ 1462-0324 ] ; 2018.
Descripteurs français
- KwdFr :
- Antagoniste du récepteur à l'interleukine-1 (usage thérapeutique), Anticorps monoclonaux humanisés (usage thérapeutique), Antirhumatismaux (usage thérapeutique), Arthrite juvénile (traitement médicamenteux), Chimiothérapie d'induction, Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Humains, Indice de gravité médicale, Modèles logistiques, Mâle, Produits biologiques (usage thérapeutique), Résultat thérapeutique.
- MESH :
- traitement médicamenteux : Arthrite juvénile.
- usage thérapeutique : Antagoniste du récepteur à l'interleukine-1, Anticorps monoclonaux humanisés, Antirhumatismaux, Produits biologiques.
- Chimiothérapie d'induction, Enfant, Enfant d'âge préscolaire, Facteurs temps, Femelle, Humains, Indice de gravité médicale, Modèles logistiques, Mâle, Résultat thérapeutique.
English descriptors
- KwdEn :
- Antibodies, Monoclonal, Humanized (therapeutic use), Antirheumatic Agents (therapeutic use), Arthritis, Juvenile (drug therapy), Biological Products (therapeutic use), Child, Child, Preschool, Female, Humans, Induction Chemotherapy, Interleukin 1 Receptor Antagonist Protein (therapeutic use), Logistic Models, Male, Severity of Illness Index, Time Factors, Treatment Outcome.
- MESH :
- chemical , therapeutic use : Antibodies, Monoclonal, Humanized, Antirheumatic Agents, Biological Products, Interleukin 1 Receptor Antagonist Protein.
- drug therapy : Arthritis, Juvenile.
- Child, Child, Preschool, Female, Humans, Induction Chemotherapy, Logistic Models, Male, Severity of Illness Index, Time Factors, Treatment Outcome.
Abstract
To investigate real-world short-term outcomes among patients with systemic JIA starting tocilizumab or anakinra.
This analysis included all systemic JIA patients within the UK Biologics for Children with Rheumatic Diseases study starting tocilizumab or anakinra between 2010 and 2016. Disease activity was assessed at baseline and one year. At one year the following outcomes were assessed: minimal disease activity, clinically inactive disease, 90% ACR Paediatric response (ACRPedi90). Univariable logistic regression was used to identify baseline characteristics associated with these outcomes. Multiple imputation was used to account for missing data.
Seventy-six systemic JIA patients were included (54 tocilizumab; 22 anakinra). More patients starting anakinra as their first biologic compared with tocilizumab (86%
In this real-world cohort of patients with systemic JIA receiving tocilizumab or anakinra, approximately half achieved a minimal disease state by one year. Treatment responses appeared similar between the two therapies albeit with better persistence observed with tocilizumab.
Url:
DOI: 10.1093/rheumatology/key262
PubMed: 30137641
PubMed Central: 6293481
Affiliations:
- Royaume-Uni
- Angleterre, Grand Manchester, Midlands de l'Ouest
- Birmingham, Manchester
- Université de Manchester
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Le document en format XML
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Beresford</name><affiliation wicri:level="1"><nlm:aff id="key262-aff2">Institute of Translational Medicine (Child Health), University of Liverpool, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Translational Medicine (Child Health), University of Liverpool</wicri:regionArea><wicri:noRegion>University of Liverpool</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="key262-aff3">Clinical Academic Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Academic Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Davies, Rebecca" sort="Davies, Rebecca" uniqKey="Davies R" first="Rebecca" last="Davies">Rebecca Davies</name><affiliation wicri:level="4"><nlm:aff id="key262-aff1">Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author><author><name sortKey="De Cock, Diederik" sort="De Cock, Diederik" uniqKey="De Cock D" first="Diederik" last="De Cock">Diederik De Cock</name><affiliation wicri:level="4"><nlm:aff id="key262-aff1">Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation></author><author><name sortKey="Baildam, Eileen" sort="Baildam, Eileen" uniqKey="Baildam E" first="Eileen" last="Baildam">Eileen Baildam</name><affiliation wicri:level="1"><nlm:aff id="key262-aff3">Clinical Academic Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Clinical Academic Department of Paediatric Rheumatology, Alder Hey Children’s NHS Foundation Trust, Liverpool</wicri:regionArea><wicri:noRegion>Liverpool</wicri:noRegion></affiliation></author><author><name sortKey="Foster, Helen E" sort="Foster, Helen E" uniqKey="Foster H" first="Helen E" last="Foster">Helen E. Foster</name><affiliation wicri:level="1"><nlm:aff id="key262-aff4">Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Cellular Medicine, Newcastle University, Newcastle upon Tyne</wicri:regionArea><wicri:noRegion>Newcastle upon Tyne</wicri:noRegion></affiliation><affiliation wicri:level="1"><nlm:aff id="key262-aff5">Paediatric Rheumatology, Great North Children’s Hospital, Newcastle upon Tyne, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Paediatric Rheumatology, Great North Children’s Hospital, Newcastle upon Tyne</wicri:regionArea><wicri:noRegion>Newcastle upon Tyne</wicri:noRegion></affiliation></author><author><name sortKey="Southwood, Taunton R" sort="Southwood, Taunton R" uniqKey="Southwood T" first="Taunton R" last="Southwood">Taunton R. Southwood</name><affiliation wicri:level="3"><nlm:aff id="key262-aff6">Institute of Child Health, University of Birmingham and Birmingham Children’s Hospital, Birmingham, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Institute of Child Health, University of Birmingham and Birmingham Children’s Hospital, Birmingham</wicri:regionArea><placeName><settlement type="city">Birmingham</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Midlands de l'Ouest</region></placeName></affiliation></author><author><name sortKey="Thomson, Wendy" sort="Thomson, Wendy" uniqKey="Thomson W" first="Wendy" last="Thomson">Wendy Thomson</name><affiliation wicri:level="4"><nlm:aff id="key262-aff7">Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Arthritis Research UK Centre for Genetics and Genomics, Manchester Academic Health Science Centre, The University of Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="key262-aff8">National Institute of Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Institute of Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author><author><name sortKey="Hyrich, Kimme L" sort="Hyrich, Kimme L" uniqKey="Hyrich K" first="Kimme L" last="Hyrich">Kimme L. Hyrich</name><affiliation wicri:level="4"><nlm:aff id="key262-aff1">Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>Arthritis Research UK Centre for Epidemiology, Manchester Academic Health Science Centre, The University of Manchester, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName><orgName type="university">Université de Manchester</orgName></affiliation><affiliation wicri:level="3"><nlm:aff id="key262-aff8">National Institute of Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester, UK</nlm:aff><country xml:lang="fr">Royaume-Uni</country><wicri:regionArea>National Institute of Health Research Manchester Biomedical Research Centre, Manchester Academic Health Science Centre, Manchester University NHS Foundation Trust, Manchester</wicri:regionArea><placeName><settlement type="city">Manchester</settlement><region type="country">Angleterre</region><region type="région" nuts="1">Grand Manchester</region></placeName></affiliation></author></analytic><series><title level="j">Rheumatology (Oxford, England)</title><idno type="ISSN">1462-0324</idno><idno type="eISSN">1462-0332</idno><imprint><date when="2018">2018</date></imprint></series></biblStruct></sourceDesc></fileDesc><profileDesc><textClass><keywords scheme="KwdEn" xml:lang="en"><term>Antibodies, Monoclonal, Humanized (therapeutic use)</term><term>Antirheumatic Agents (therapeutic use)</term><term>Arthritis, Juvenile (drug therapy)</term><term>Biological Products (therapeutic use)</term><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Induction Chemotherapy</term><term>Interleukin 1 Receptor Antagonist Protein (therapeutic use)</term><term>Logistic Models</term><term>Male</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="KwdFr" xml:lang="fr"><term>Antagoniste du récepteur à l'interleukine-1 (usage thérapeutique)</term><term>Anticorps monoclonaux humanisés (usage thérapeutique)</term><term>Antirhumatismaux (usage thérapeutique)</term><term>Arthrite juvénile (traitement médicamenteux)</term><term>Chimiothérapie d'induction</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Modèles logistiques</term><term>Mâle</term><term>Produits biologiques (usage thérapeutique)</term><term>Résultat thérapeutique</term></keywords><keywords scheme="MESH" type="chemical" qualifier="therapeutic use" xml:lang="en"><term>Antibodies, Monoclonal, Humanized</term><term>Antirheumatic Agents</term><term>Biological Products</term><term>Interleukin 1 Receptor Antagonist Protein</term></keywords><keywords scheme="MESH" qualifier="drug therapy" xml:lang="en"><term>Arthritis, Juvenile</term></keywords><keywords scheme="MESH" qualifier="traitement médicamenteux" xml:lang="fr"><term>Arthrite juvénile</term></keywords><keywords scheme="MESH" qualifier="usage thérapeutique" xml:lang="fr"><term>Antagoniste du récepteur à l'interleukine-1</term><term>Anticorps monoclonaux humanisés</term><term>Antirhumatismaux</term><term>Produits biologiques</term></keywords><keywords scheme="MESH" xml:lang="en"><term>Child</term><term>Child, Preschool</term><term>Female</term><term>Humans</term><term>Induction Chemotherapy</term><term>Logistic Models</term><term>Male</term><term>Severity of Illness Index</term><term>Time Factors</term><term>Treatment Outcome</term></keywords><keywords scheme="MESH" xml:lang="fr"><term>Chimiothérapie d'induction</term><term>Enfant</term><term>Enfant d'âge préscolaire</term><term>Facteurs temps</term><term>Femelle</term><term>Humains</term><term>Indice de gravité médicale</term><term>Modèles logistiques</term><term>Mâle</term><term>Résultat thérapeutique</term></keywords></textClass></profileDesc></teiHeader><front><div type="abstract" xml:lang="en"><title>Abstract</title><sec id="s1"><title>Objectives</title><p>To investigate real-world short-term outcomes among patients with systemic JIA starting tocilizumab or anakinra.</p></sec><sec id="s2"><title>Methods</title><p>This analysis included all systemic JIA patients within the UK Biologics for Children with Rheumatic Diseases study starting tocilizumab or anakinra between 2010 and 2016. Disease activity was assessed at baseline and one year. At one year the following outcomes were assessed: minimal disease activity, clinically inactive disease, 90% ACR Paediatric response (ACRPedi90). Univariable logistic regression was used to identify baseline characteristics associated with these outcomes. Multiple imputation was used to account for missing data.</p></sec><sec id="s3"><title>Results</title><p>Seventy-six systemic JIA patients were included (54 tocilizumab; 22 anakinra). More patients starting anakinra as their first biologic compared with tocilizumab (86% <italic>vs</italic> 63%; <italic>P</italic> = 0.04), with shorter disease duration (1 <italic>vs</italic> 2 years; <italic>P</italic> = 0.003) and higher frequency of prior macrophage activation syndrome (37% <italic>vs</italic> 8%; <italic>P</italic> = 0.004). Overall, at one year, 42% achieved ACRPedi90, 51% minimal disease activity, and 39% clinically inactive disease, with similar responses seen between the two drugs. Response was not associated with baseline disease characteristics. Fifteen (20%) patients stopped biologic treatment by one year. Treatment survival was better with tocilizumab (89% at one year <italic>vs</italic> 59% anakinra; <italic>P</italic> = 0.002), with three stopping for anakinra injection-related problems.</p></sec><sec id="s4"><title>Conclusion</title><p>In this real-world cohort of patients with systemic JIA receiving tocilizumab or anakinra, approximately half achieved a minimal disease state by one year. 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Hyrich</name></author></analytic></biblStruct></listBibl></div1></back></TEI><affiliations><list><country><li>Royaume-Uni</li></country><region><li>Angleterre</li><li>Grand Manchester</li><li>Midlands de l'Ouest</li></region><settlement><li>Birmingham</li><li>Manchester</li></settlement><orgName><li>Université de Manchester</li></orgName></list><tree><country name="Royaume-Uni"><region name="Angleterre"><name sortKey="Kearsley Fleet, Lianne" sort="Kearsley Fleet, Lianne" uniqKey="Kearsley Fleet L" first="Lianne" last="Kearsley-Fleet">Lianne Kearsley-Fleet</name></region><name sortKey="Baildam, Eileen" sort="Baildam, Eileen" uniqKey="Baildam E" first="Eileen" last="Baildam">Eileen Baildam</name><name sortKey="Beresford, Michael W" sort="Beresford, Michael W" uniqKey="Beresford M" first="Michael W" last="Beresford">Michael W. Beresford</name><name sortKey="Beresford, Michael W" sort="Beresford, Michael W" uniqKey="Beresford M" first="Michael W" last="Beresford">Michael W. Beresford</name><name sortKey="Davies, Rebecca" sort="Davies, Rebecca" uniqKey="Davies R" first="Rebecca" last="Davies">Rebecca Davies</name><name sortKey="De Cock, Diederik" sort="De Cock, Diederik" uniqKey="De Cock D" first="Diederik" last="De Cock">Diederik De Cock</name><name sortKey="Foster, Helen E" sort="Foster, Helen E" uniqKey="Foster H" first="Helen E" last="Foster">Helen E. Foster</name><name sortKey="Foster, Helen E" sort="Foster, Helen E" uniqKey="Foster H" first="Helen E" last="Foster">Helen E. Foster</name><name sortKey="Hyrich, Kimme L" sort="Hyrich, Kimme L" uniqKey="Hyrich K" first="Kimme L" last="Hyrich">Kimme L. Hyrich</name><name sortKey="Hyrich, Kimme L" sort="Hyrich, Kimme L" uniqKey="Hyrich K" first="Kimme L" last="Hyrich">Kimme L. Hyrich</name><name sortKey="Southwood, Taunton R" sort="Southwood, Taunton R" uniqKey="Southwood T" first="Taunton R" last="Southwood">Taunton R. Southwood</name><name sortKey="Thomson, Wendy" sort="Thomson, Wendy" uniqKey="Thomson W" first="Wendy" last="Thomson">Wendy Thomson</name><name sortKey="Thomson, Wendy" sort="Thomson, Wendy" uniqKey="Thomson W" first="Wendy" last="Thomson">Wendy Thomson</name></country></tree></affiliations></record>Pour manipuler ce document sous Unix (Dilib)
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