AUTHOR=Sota Jurgen , Insalaco Antonella , Cimaz Rolando , Alessio Maria , Cattalini Marco , Gallizzi Romina , Maggio Maria Cristina , Lopalco Giuseppe , La Torre Francesco , Fabiani Claudia , Pardeo Manuela , Olivieri Alma Nunzia , Sfriso Paolo , Salvarani Carlo , Gaggiano Carla , Grosso Salvatore , Bracaglia Claudia , De Benedetti Fabrizio , Rigante Donato , Cantarini Luca 

TITLE=Drug Retention Rate and Predictive Factors of Drug Survival for Interleukin-1 Inhibitors in Systemic Juvenile Idiopathic Arthritis

JOURNAL=Frontiers in Pharmacology

VOLUME=Volume 9 - 2018

YEAR=2019

URL=https://www.frontiersin.org/journals/pharmacology/articles/10.3389/fphar.2018.01526

DOI=10.3389/fphar.2018.01526

ISSN=1663-9812

ABSTRACT=Background and objectives: few studies have reported the drug retention rate (DRR) of biologic drugs in juvenile idiopathic arthritis (JIA), and none of them has specifically investigated the DRR of interleukin (IL)-1 inhibitors on systemic JIA (sJIA). This study aims to describe IL-1 inhibitors DRR and evaluate predictive factors of drug survival based on data from a real-world setting concerning sJIA. Methods: Medical records from sJIA patients treated with anakinra (ANA) and canakinumab (CAN) were retrospectively analyzed from 15 Italian tertiary referral centers. Results: Seventy seven patients were enrolled for a total of 86 treatment courses. The cumulative retention rate of the IL-1 inhibitors at 12-, 24-, 48- and 60-months of follow-up was 79.9%, 59.5%, 53.5% and 53.5% respectively, without any statistically significant differences between ANA and CAN (p=0.056), and between patients treated in monotherapy compared to the subgroup co-administered with conventional immunosuppressors (p=0.058). On the contrary, significant differences were found between biologic-naive patients and those previously treated with biologic drugs (p=0.038) and when distinguishing according to adverse events (AEs) occurrence (p=0.04). In regression analysis, patients pre-treated with other biologics (HR=3.357 [C.I. 1.341-8.406], p=0.01) and those experiencing AEs (HR=2.970 [C.I. 1.186-7.435], p=0.020) were associated with a higher hazard ratio of IL-1 inhibitors withdrawal. The mean treatment delay was significantly higher among patients discontinuing IL-1 inhibitors (p=0.0002). Conclusions: Our findings suggest an excellent overall DRR for both ANA and CAN that might be further augmented by paying attention to AEs and employing these agents as first-line biologics in the early stages.