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Earlier Anakinra Initiation Warranted in Still's Disease

Jack Cush, MD
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An Italian study examined the outcomes in adult onset Still’s disease (AOSD) based on whether they received early or delayed treatment with anakinra (ANK). 

A total of 141 AOSD patients were retrospectively studied.

Overall, they found no differences in efficacy if ANK was started within 6 (or 12 mos) vs. thereafter.  

However, starting ANK earlier (< 6 or <12 months) resulted in faster reductions in erythrocyte sedimentation rate and C-reactive protein levels and faster reduction in the number of swollen joints (p = 0.01).  Radar graphics show that IL-1 inhibition was more effective at more disease domains than were conventional DMARDs or other biologics. 

ANK effectiveness in controlling systemic inflammation and resolving articular manifestations is more obvious when IL-1 inhibition is initiated soon after disease onset.

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