title: Anakinra in Systemic Juvenile Idiopathic Arthritis: A Single-center Experience.
abstract: OBJECTIVE
  To assess anakinra as a therapy for systemic juvenile idiopathic arthritis (sJIA) in a single-center series.
  
  
  METHODS
  We reviewed 25 patients with sJIA treated with anakinra for at least 6 months. The primary outcome was the number of patients who achieved clinically inactive disease at 6 months, according to preliminary criteria for inactive disease and clinical remission of JIA.
  
  
  RESULTS
  Among 25 patients evaluated, 14 (56%) met the criteria for inactive disease at 6 months and were classified as responders. For each individual patient, we compared the dose administered with the ideal dose of anakinra and we found that there was no relation with response. We also compared demographic characteristics and clinical and laboratory features at baseline in responders and non-responders: no differences were observed in relation with the number of active joints before starting anakinra or concomitant glucocorticoids treatment. The only variable significantly associated with response was the time from disease onset to receiving anakinra, with earlier treatment being associated with a better outcome.
  
  
  CONCLUSIONS
  Anakinra is associated with rapid attainment of inactive disease in a significant portion of patients. We found that only the earlier treatment is associated with better outcome. However, formal studies on early treatment and on the pathophysiology and response to treatments, including anakinra, of early- and late-onset sJIA are needed to optimize the management of this challenging disease.
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS. manuela.pardeo@opbg.net fabrizio.debenedetti@opbg.net.
authors.forename: Manuela
authors.initials: M
authors.lastname: Pardeo
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
authors.forename: Denise
authors.initials: D
authors.lastname: Pires Marafon
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
authors.forename: Antonella
authors.initials: A
authors.lastname: Insalaco
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
authors.forename: Claudia
authors.initials: C
authors.lastname: Bracaglia
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
authors.forename: Rebecca
authors.initials: R
authors.lastname: Nicolai
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS.
authors.forename: Virginia
authors.initials: V
authors.lastname: Messia
authors.affiliation: From the Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, Istituto di Ricovero e Cura a Carattere Scientifico (IRCCS), Rome, Italy.M. Pardeo, MD; D. Pires Marafon, MD; A. Insalaco, MD; C. Bracaglia, MD; R. Nicolai, MD; V. Messia, MD; F. De Benedetti, MD, Division of Rheumatology, Department of Pediatric Medicine, Bambino Gesù Children's Hospital, IRCCS. manuela.pardeo@opbg.net fabrizio.debenedetti@opbg.net.
authors.forename: Fabrizio
authors.initials: F
authors.lastname: De Benedetti
mesh_terms: D018501:Antirheumatic Agents / Q000627:therapeutic use*; D001171:Arthritis, Juvenile / Q000188:drug therapy*; D002648:Child; D002675:Child, Preschool; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D008297:Male; D012074:Remission Induction; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein
keywords: ANAKINRA; CLINICAL INACTIVE DISEASE; DOSE ADMINISTERED; SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS