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. 2023 Dec 12:10:1256243.
doi: 10.3389/fmed.2023.1256243. eCollection 2023.

Efficacy of canakinumab in patients with Still's disease across different lines of biologic therapy: real-life data from the International AIDA Network Registry for Still's Disease

Antonio Vitale  1   2 , Valeria Caggiano  1   2 , Petros P Sfikakis  3 , Lorenzo Dagna  4   5 , Giuseppe Lopalco  6 , Gaafar Ragab  7   8 , Francesco La Torre  9 , Ibrahim A Almaghlouth  10   11 , Maria Cristina Maggio  12 , Jurgen Sota  1   2 , Abdurrahman Tufan  13 , Andrea Hinojosa-Azaola  14 , Florenzo Iannone  6 , Roberta Loconte  9 , Katerina Laskari  15 , Haner Direskeneli  16 , Piero Ruscitti  17 , Maria Morrone  6 , Henrique A Mayrink Giardini  18 , Alexandros Panagiotopoulos  3 , Ilenia Di Cola  17 , Eduardo Martín-Nares  14 , Sara Monti  19   20 , Ludovico De Stefano  19   20 , Rıza Can Kardas  13 , Rahime Duran  13 , Corrado Campochiaro  4   5 , Alessandro Tomelleri  4   5 , Abdulaziz Mohammed Alabdulkareem  10 , Carla Gaggiano  1   2 , Maria Tarsia  21   2 , Elena Bartoloni  22 , Mery Romeo  23 , Mohamed A Hussein  7 , Ahmed Hatem Laymouna  7 , Isabele Parente de Brito Antonelli  18 , Marilia Ambiel Dagostin  18 , Lampros Fotis  24 , Sara Bindoli  25 , Luca Navarini  26   27 , Fatma Alibaz-Oner  16 , Gizem Sevik  16 , Micol Frassi  28 , Francesco Ciccia  29 , Daniela Iacono  29 , Francesca Crisafulli  28 , Piero Portincasa  30 , Nour Jaber  30 , Perla Ayumi Kawakami-Campos  31 , Ewa Wiesik-Szewczyk  32 , Annamaria Iagnocco  33 , Gabriele Simonini  34 , Paolo Sfriso  25 , Alberto Balistreri  35 , Roberto Giacomelli  26   27 , Giovanni Conti  23 , Bruno Frediani  1   2 , Claudia Fabiani  36   2 , Luca Cantarini  1   2
Affiliations

Efficacy of canakinumab in patients with Still's disease across different lines of biologic therapy: real-life data from the International AIDA Network Registry for Still's Disease

Antonio Vitale et al. Front Med (Lausanne). .

Abstract

Introduction: The effectiveness of canakinumab may change according to the different times it is used after Still's disease onset. This study aimed to investigate whether canakinumab (CAN) shows differences in short- and long-term therapeutic outcomes, according to its use as different lines of biologic treatment.

Methods: Patients included in this study were retrospectively enrolled from the AutoInflammatory Disease Alliance (AIDA) International Registry dedicated to Still's disease. Seventy-seven (51 females and 26 males) patients with Still's disease were included in the present study. In total, 39 (50.6%) patients underwent CAN as a first-line biologic agent, and the remaining 38 (49.4%) patients were treated with CAN as a second-line biologic agent or subsequent biologic agent.

Results: No statistically significant differences were found between patients treated with CAN as a first-line biologic agent and those previously treated with other biologic agents in terms of the frequency of complete response (p =0.62), partial response (p =0.61), treatment failure (p >0.99), and frequency of patients discontinuing CAN due to lack or loss of efficacy (p =0.2). Of all the patients, 18 (23.4%) patients experienced disease relapse during canakinumab treatment, 9 patients were treated with canakinumab as a first-line biologic agent, and nine patients were treated with a second-line or subsequent biologic agent. No differences were found in the frequency of glucocorticoid use (p =0.34), daily glucocorticoid dosage (p =0.47), or concomitant methotrexate dosage (p =0.43) at the last assessment during CAN treatment.

Conclusion: Canakinumab has proved to be effective in patients with Still's disease, regardless of its line of biologic treatment.

Keywords: AOSD; AutoInflammatory diseases; personalized medicine; rare diseases; treatment.

PubMed Disclaimer

Conflict of interest statement

The authors declare that the research was conducted in the absence of any commercial or financial relationships that could be construed as a potential conflict of interest.

Figures

Figure 1
Figure 1
Still’s disease manifestations observed at the start of canakinumab and those persisting after 3 months of treatment.
Figure 2
Figure 2
Still’s disease clinical manifestations observed at the 3-month visit (A), those proving to be more resistant after the start of canakinumab (CAN) and during the entire follow-up (B), those observed during relapses while on CAN treatment (C), and those recorded at the time of combination with conventional disease-modifying anti-rheumatic drugs (cDMARDs) (D). Clinical manifestations have been colored in order to distinguish the frequencies of patients treated with CAN as a first-line biologic agent and the frequencies drawn from patients previously treated with other biologic agents in the past. Numbers on the y-axis refer to the number of patients involved with disease manifestations.
Figure 3
Figure 3
Treatment outcomes with canakinumab used as first-line biologic agent (1st line) or as second-line or subsequent biologic agent. p-values were obtained by using the Fisher exact test.
Figure 4
Figure 4
Global treatment outcomes after canakinumab (CAN) introduction among patients administered with their first-line biologic agent, distinguishing between cases starting treatment prior to and after 6 months from at the start of CAN (13 and 26 patients, respectively) (A) and prior to and after 12 months from at the start of CAN (20 and 19 patients, respectively) (B). The y-axis refers to the percentage of response compared to the total number of patients included in each group; p-values of were obtained using the Chi-square test or the Fisher exact test, according to the frequency counts.
See this image and copyright information in PMC

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