dc.contributor.author |
Ortiz Sanjuán, Francisco |
dc.contributor.author |
Blanco, Ricardo |
dc.contributor.author |
Riancho Zarrabeitia, Leyre |
dc.contributor.author |
Castañeda, Santos |
dc.contributor.author |
Olivé Marqués, Alejandro |
dc.contributor.author |
Riveros, Anne |
dc.contributor.author |
Velloso Feijoo, María L. |
dc.contributor.author |
Narváez, Javier |
dc.contributor.author |
Jiménez Moleón, Inmaculada |
dc.contributor.author |
Maiz Alonso, Olga |
dc.contributor.author |
Ordóñez, Carmen |
dc.contributor.author |
Bernal-Vidal, José Antonio |
dc.contributor.author |
Hernández, María V. |
dc.contributor.author |
Sifuentes Giraldo, Walter A. |
dc.contributor.author |
Gómez Arango, Catalina |
dc.contributor.author |
Galíndez Agirregoikoa, Eva |
dc.contributor.author |
Blanco-Madrigal, J.M |
dc.contributor.author |
Ortiz Santamaría, Vera |
dc.contributor.author |
Blanco Barnusell, Jordi del |
dc.contributor.author |
Dios, Juan R. de |
dc.contributor.author |
Moreno Martínez-Losa, Mireia |
dc.contributor.author |
Fiter, Jordi |
dc.contributor.author |
Riscos, Marina de los |
dc.contributor.author |
Carreira, Patricia |
dc.contributor.author |
Rodriguez Valls, María J. |
dc.contributor.author |
González Vela, M. Carmen |
dc.contributor.author |
Calvo Río, Vanesa |
dc.contributor.author |
Loricera, Javier |
dc.contributor.author |
Palmou Fontana, Natalia |
dc.contributor.author |
Pina, Trinitario |
dc.contributor.author |
Llorca, Javier |
dc.contributor.author |
Gonzalez-Gay, MA |
dc.date |
2015 |
dc.identifier |
https://ddd.uab.cat/record/163157 |
dc.identifier |
urn:10.1097/MD.0000000000001554 |
dc.identifier |
urn:oai:ddd.uab.cat:163157 |
dc.identifier |
urn:pmid:26426623 |
dc.identifier |
urn:scopus_id:84943195545 |
dc.identifier |
urn:wos_id:000369534600021 |
dc.identifier |
urn:altmetric_id:4584437 |
dc.identifier |
urn:pmc-uid:4616841 |
dc.identifier |
urn:pmcid:PMC4616841 |
dc.identifier |
urn:oai:pubmedcentral.nih.gov:4616841 |
dc.format |
application/pdf |
dc.language |
eng |
dc.publisher |
|
dc.relation |
Medicine ; Vol. 94 Núm. 39 (september 2015) |
dc.rights |
open access |
dc.rights |
Aquest document està subjecte a una llicència d'ús Creative Commons. Es permet la reproducció total o parcial, la distribució, la comunicació pública de l'obra i la creació d'obres derivades, fins i tot amb finalitats comercials, sempre i quan es reconegui l'autoria de l'obra original. |
dc.rights |
https://creativecommons.org/licenses/by/3.0/ |
dc.subject |
Artritis reumatoide |
dc.subject |
Adult-Onset Still's Disease |
dc.subject |
AOSD |
dc.subject |
Anakinra |
dc.title |
Efficacy of Anakinra in Refractory Adult-Onset Still's Disease: Multicenter Study of 41 Patients and Literature Review |
dc.type |
Article |
dc.description.abstract |
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. |