%0 Journal Article
%A Ortiz-Sanjuán, Francisco
%A Blanco, Ricardo
%A Riancho-Zarrabeitia, Leyre
%A Castañeda, Santos
%A Olivé, Alejandro
%A Riveros, Anne
%A Velloso-Feijoo, María L
%A Narváez, Javier
%A Jiménez-Moleón, Inmaculada
%A Maiz-Alonso, Olga
%A Ordóñez, Carmen
%A Bernal, José A
%A Hernández, María V
%A Sifuentes-Giraldo, Walter A
%A Gómez-Arango, Catalina
%A Galíndez-Agirregoikoa, Eva
%A Blanco-Madrigal, Juan
%A Ortiz-Santamaria, Vera
%A del Blanco-Barnusell, Jordi
%A De Dios, Juan R
%A Moreno, Mireia
%A Fiter, Jordi
%A de los Riscos, Marina
%A Carreira, Patricia
%A Rodriguez-Valls, María J
%A González-Vela, M Carmen
%A Calvo-Río, Vanesa
%A Loricera, Javier
%A Palmou-Fontana, Natalia
%A Pina, Trinitario
%A Llorca, Javier
%A González-Gay, Miguel A
%T Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review.
%D 2015
%@ 0025-7974
%U http://hdl.handle.net/10668/2626
%X 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.
%K Adulto
%K Quimioterapia combinada
%K Femenino
%K Humanos
%K Inmunosupresores
%K Proteína antagonista del receptor de interleucina 1
%K Masculino
%K Mediana edad
%K Prednisona
%K Estudios retrospectivos
%K Enfermedad de Still del adulto
%~