Update on the therapy of adult-onset Still’s disease with a focus on IL-1-inhibition: a systematic review
| Title: | Update on the therapy of adult-onset Still’s disease with a focus on IL-1-inhibition: a systematic review |
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| Authors: | Claudia Kedor, Stylianos Tomaras, Daniel Baeumer, Eugen Feist |
| Source: | Therapeutic Advances in Musculoskeletal Disease, Vol 13 (2021) |
| Publisher Information: | SAGE Publishing, 2021. |
| Publication Year: | 2021 |
| Collection: | LCC:Diseases of the musculoskeletal system |
| Subject Terms: | Diseases of the musculoskeletal system, RC925-935 |
| More Details: | Introduction: The past decade has seen increasingly rapid advances in understanding the pathogenic nature of adult-onset Still’s disease (AOSD) and its shared symptoms with the systemic juvenile idiopathic arthritis (sJIA). Interleukin-1 (IL-1) blocking agents are key elements in the treatment. In this updated systematic review, we focus on studies on efficacy and safety of IL-1 blockers published in the past 5 years and review on latest available therapies. Methods: We conducted searches using Medline, Biosis, Embase, and Cochrane databases between 2016 and 2021 using the terms AOSD, IL1, IL-18, canakinumab, anakinra, tadekinig, and rilonacept and if applicable their trade names. Duplicates, case reports, and manuscripts with incomplete data were excluded. Results: Of the 1013 screened publications, 17 were eligible after careful selection. We only found two published randomized controlled studies in the past 5 years. Review manuscripts of rare diseases, like our work, usually rely on retrospective studies and case series. Anakinra and canakinumab can be successfully used as first- or further-line treatment in patients with AOSD refractory to steroids. A homogeneous outcome is not established yet. Thus, a combination of clinical and laboratory tests can support the experienced clinician in the decision-making process. Conclusion: The approval of IL-1 inhibitors for AOSD brought us into a new era in the treatment of AOSD. The overall efficacy-safety profile of the IL-1 inhibitors is favorable reflecting a targeted approach as standard of care. We can expect that the successful treatment of AOSD with IL-1 inhibition will facilitate further clinical and basic research with impact on other auto-inflammatory and hyper-inflammatory conditions. |
| Document Type: | article |
| File Description: | electronic resource |
| Language: | English |
| ISSN: | 1759-7218 1759720X |
| Relation: | https://doaj.org/toc/1759-7218 |
| DOI: | 10.1177/1759720X211059598 |
| Access URL: | https://doaj.org/article/dee9f4fe5cf94ac3bd725ba8d1336885 |
| Accession Number: | edsdoj.9f4fe5cf94ac3bd725ba8d1336885 |
| Database: | Directory of Open Access Journals |
| ISSN: | 17597218 1759720X |
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| DOI: | 10.1177/1759720X211059598 |
| Published in: | Therapeutic Advances in Musculoskeletal Disease |
| Language: | English |