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Earlier Anakinra Initiation Warranted in Still's Disease

Jack Cush, MD

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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