Most Read Articles
Tristan Manalac, 4 days ago
The causes, presentations and management of anaphylaxis vary considerably with age, according to a recent Singapore study, which reported that children are more likely to present with food anaphylaxis, while drug anaphylaxis is more common in adults.
Pearl Toh, 3 days ago
Low-density lipoprotein cholesterol (LDL-C) levels remained high in many patients with stable or acute coronary heart disease (CHD) in Asia, despite having a very high risk of recurrent cardiovascular (CV) events, indicating that the use of lipid-lowering therapies and lipid monitoring were inadequate.
13 Sep 2018
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.
2 days ago
There is a strong association between smoking duration and colorectal polyps, independent of smoking intensity, cessation and other potential confounders, reports a recent study. Such association is more robust with distal rather than proximal polyps, and with serrated polyps rather than adenomas.

Anakinra, tocilizumab both effective against systemic juvenile idiopathic arthritis

14 Sep 2018

Treatment with either anakinra or tocilizumab results in minimal disease activity in a significant number of patients with systemic juvenile idiopathic arthritis (JIA), a recent study has shown. Response to treatment appears to be similar despite better adherence observed with tocilizumab.

The study included 76 systemic JIA patients, among whom 54 were on tocilizumab and 22 on anakinra. Outcomes evaluated included minimal disease activity, clinically inactive disease and 90 percent ACR Paediatric response (ACRPedi90) at 1 year.

Significantly more patients started anakinra vs tocilizumab as their first biologic treatment (86 percent vs 63 percent; p=0.04). Those in the anakinra group were more likely to have shorter disease duration (1 vs 2 years; p=0.003) and prior macrophage activation syndrome (MAS; 37 percent vs 8 percent; p=0.004).

In the entire cohort, at 1 year, 42 percent of patients achieved ACRPedi90, 51 percent minimal disease activity and 39 percent clinically inactive disease. Responses were similar between the anakinra and tocilizumab groups. Response showed no association with baseline disease characteristics.

A total of 15 patients (20 percent) withdrew biologic treatment by 1 year. Treatment survival was better with tocilizumab (89 percent vs 59 percent; p=0.002), with three patients on anakinra discontinuing treatment due to injection-related problems.

Anakinra is currently recommended in the first-line treatment of patients with active MAS, as it may help recovery. In the study cohort, however, only five of the 19 patients starting anakinra as a first-line biologic had a reported history of MAS.

The finding of anakinra being used first-line in some patients, despite the availability of tocilizumab, potentially reflects clinician preference and therefore warrants further exploration, researchers said. This may have important implications with regard to informing future treatment guidelines for systemic JIA.

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Most Read Articles
Tristan Manalac, 4 days ago
The causes, presentations and management of anaphylaxis vary considerably with age, according to a recent Singapore study, which reported that children are more likely to present with food anaphylaxis, while drug anaphylaxis is more common in adults.
Pearl Toh, 3 days ago
Low-density lipoprotein cholesterol (LDL-C) levels remained high in many patients with stable or acute coronary heart disease (CHD) in Asia, despite having a very high risk of recurrent cardiovascular (CV) events, indicating that the use of lipid-lowering therapies and lipid monitoring were inadequate.
13 Sep 2018
Substituting diets high in carbohydrates with those high in monounsaturated fatty acids in the context of low saturated fatty acids do not appear to yield favourable effects on blood pressure, according to a meta-analysis.
2 days ago
There is a strong association between smoking duration and colorectal polyps, independent of smoking intensity, cessation and other potential confounders, reports a recent study. Such association is more robust with distal rather than proximal polyps, and with serrated polyps rather than adenomas.