title: Long-term efficacy and safety profile of rilonacept in the treatment of cryopryin-associated periodic syndromes: results of a 72-week open-label extension study.
abstract: BACKGROUND
  Cryopyrin-associated periodic syndromes (CAPS) are rare, inherited autoinflammatory disorders associated with considerable hardship to patients. The interleukin-1 inhibitor rilonacept has been shown to be well-tolerated and effective in preventing CAPS symptoms in 2 pivotal studies.
  
  
  OBJECTIVE
  In this study, the long-term effects of rilonacept for improvement in CAPS symptoms and its safety and tolerability were evaluated during extended treatment.
  
  
  METHODS
  Patients with CAPS entered a 72-week open-label extension (OLE) following 2 sequential placebo-controlled Phase III studies (n = 44), or entered directly into the OLE (n = 57). Adults received weekly subcutaneous rilonacept 160 mg, and pediatric patients received subcutaneous rilonacept 2.2 mg/kg, up to 160 mg/week. Safety was evaluated in all patients, and efficacy was evaluated using a validated composite key symptom score in 56 patients.
  
  
  RESULTS
  After rilonacept treatment for 72 to 96 weeks mean key symptom score at OLE Week 72 was reduced from 2.6 to 0, and the mean number of multisymptom flare days was reduced from 7.3 (34.8% of days) at baseline to 0.6 (2.9% of days) at end point. Elevated levels of inflammatory markers (eg, high sensitivity-C reactive protein and serum amyloid A, were normalized. Adverse events were generally mild to moderate, the most common being injection site reactions and upper respiratory tract infections. The incidence of these events was similar to or lower than the rate reported in the pivotal studies.
  
  
  CONCLUSIONS
  Long-term treatment with rilonacept of up to 96 weeks resulted in improvements in clinical signs and symptoms of CAPS and normalized biomarkers of inflammation. Rilonacept exhibited a generally favorable safety and tolerability profile in adult and pediatric patients with CAPS throughout the extended treatment period. ClinicalTrials.gov identifier: NCT 00288704.
authors.affiliation: University of California-San Diego, La Jolla, USA. hahoffman@ucsd.edu
authors.forename: Hal M
authors.initials: HM
authors.lastname: Hoffman
authors.forename: Martin L
authors.initials: ML
authors.lastname: Throne
authors.forename: Niran J
authors.initials: NJ
authors.lastname: Amar
authors.forename: Robert C
authors.initials: RC
authors.lastname: Cartwright
authors.forename: Alan J
authors.initials: AJ
authors.lastname: Kivitz
authors.forename: Yuhwen
authors.initials: Y
authors.lastname: Soo
authors.forename: Steven P
authors.initials: SP
authors.lastname: Weinstein
mesh_terms: D000293:Adolescent; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D015415:Biomarkers / Q000378:metabolism; D002097:C-Reactive Protein / Q000378:metabolism; D002648:Child; D056587:Cryopyrin-Associated Periodic Syndromes / Q000188:drug therapy*; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D007375:Interleukin-1 / Q000037:antagonists & inhibitors*; D008297:Male; D008875:Middle Aged; D011446:Prospective Studies; D011993:Recombinant Fusion Proteins / Q000009:adverse effects / Q000627:therapeutic use*; D000685:Serum Amyloid A Protein / Q000378:metabolism; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D015415:Biomarkers; D007375:Interleukin-1; D011993:Recombinant Fusion Proteins; D000685:Serum Amyloid A Protein; C531377:rilonacept; D002097:C-Reactive Protein