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Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study
BACKGROUND AND OBJECTIVE: Evidence for the treatment of multisystem inflammatory syndrome in children (MIS-C) is lacking. Anakinra, which targets IL-1-mediated inflammation, is reserved for refractory cases of MIS-C; however, its use in the treatment of MIS-C is not clearly established. PATIENTS AND...
Autores principales: | , , , , , , , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2023
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388456/ https://www.ncbi.nlm.nih.gov/pubmed/37525200 http://dx.doi.org/10.1186/s12969-023-00858-z |
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author | Dizon, Brian L.P. Redmond, Christopher Gotschlich, Emily C. Sule, Sangeeta Ronis, Tova Vazzana, Kathleen M. Sherman, Matthew A. Connor, Rachael Bosk, Abigail Dham, Niti Harahsheh, Ashraf S. Wells, Elizabeth DeBiasi, Roberta Srinivasalu, Hemalatha |
author_facet | Dizon, Brian L.P. Redmond, Christopher Gotschlich, Emily C. Sule, Sangeeta Ronis, Tova Vazzana, Kathleen M. Sherman, Matthew A. Connor, Rachael Bosk, Abigail Dham, Niti Harahsheh, Ashraf S. Wells, Elizabeth DeBiasi, Roberta Srinivasalu, Hemalatha |
author_sort | Dizon, Brian L.P. |
collection | PubMed |
description | BACKGROUND AND OBJECTIVE: Evidence for the treatment of multisystem inflammatory syndrome in children (MIS-C) is lacking. Anakinra, which targets IL-1-mediated inflammation, is reserved for refractory cases of MIS-C; however, its use in the treatment of MIS-C is not clearly established. PATIENTS AND METHODS: To examine a role for anakinra in MIS-C, we performed a single center observational cohort study of all MIS-C patients diagnosed at our children’s hospital from May 15 to November 15, 2020. Demographics, clinical features, diagnostic testing, and cardiac function parameters were compared between MIS-C patients treated with intravenous immunoglobulin (IVIG) monotherapy and IVIG with anakinra (IVIG + anakinra). RESULTS: Among 46 patients with confirmed MIS-C, 32 (70%) were in the IVIG + anakinra group, of which 9 (28%) were also given corticosteroids (CS). No patients were treated with anakinra alone. MIS-C patients in the IVIG + anakinra group were enriched in a CV shock phenotype (p = 0.02), and those with CV shock were treated with higher doses of anakinra for a longer duration. Furthermore, MIS-C patients in the IVIG + anakinra group exhibited improvements in fever and cardiac function with or without CS. No significant adverse events were observed, and no differences in IL-1β levels were found among MIS-C patients in the IVIG + anakinra group. CONCLUSIONS: Anakinra treatment, which was co-administered with IVIG primarily in patients with severe MIS-C, was associated with improvements in fever and cardiac function, and demonstrated a favorable side-effect profile. These findings suggest a role for adjunctive anakinra in the treatment of severe MIS-C. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00858-z. |
format | Online Article Text |
id | pubmed-10388456 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2023 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-103884562023-08-01 Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study Dizon, Brian L.P. Redmond, Christopher Gotschlich, Emily C. Sule, Sangeeta Ronis, Tova Vazzana, Kathleen M. Sherman, Matthew A. Connor, Rachael Bosk, Abigail Dham, Niti Harahsheh, Ashraf S. Wells, Elizabeth DeBiasi, Roberta Srinivasalu, Hemalatha Pediatr Rheumatol Online J Research Article BACKGROUND AND OBJECTIVE: Evidence for the treatment of multisystem inflammatory syndrome in children (MIS-C) is lacking. Anakinra, which targets IL-1-mediated inflammation, is reserved for refractory cases of MIS-C; however, its use in the treatment of MIS-C is not clearly established. PATIENTS AND METHODS: To examine a role for anakinra in MIS-C, we performed a single center observational cohort study of all MIS-C patients diagnosed at our children’s hospital from May 15 to November 15, 2020. Demographics, clinical features, diagnostic testing, and cardiac function parameters were compared between MIS-C patients treated with intravenous immunoglobulin (IVIG) monotherapy and IVIG with anakinra (IVIG + anakinra). RESULTS: Among 46 patients with confirmed MIS-C, 32 (70%) were in the IVIG + anakinra group, of which 9 (28%) were also given corticosteroids (CS). No patients were treated with anakinra alone. MIS-C patients in the IVIG + anakinra group were enriched in a CV shock phenotype (p = 0.02), and those with CV shock were treated with higher doses of anakinra for a longer duration. Furthermore, MIS-C patients in the IVIG + anakinra group exhibited improvements in fever and cardiac function with or without CS. No significant adverse events were observed, and no differences in IL-1β levels were found among MIS-C patients in the IVIG + anakinra group. CONCLUSIONS: Anakinra treatment, which was co-administered with IVIG primarily in patients with severe MIS-C, was associated with improvements in fever and cardiac function, and demonstrated a favorable side-effect profile. These findings suggest a role for adjunctive anakinra in the treatment of severe MIS-C. SUPPLEMENTARY INFORMATION: The online version contains supplementary material available at 10.1186/s12969-023-00858-z. BioMed Central 2023-07-31 /pmc/articles/PMC10388456/ /pubmed/37525200 http://dx.doi.org/10.1186/s12969-023-00858-z Text en © The Author(s) 2023 https://creativecommons.org/licenses/by/4.0/Open Access This article is licensed under a Creative Commons Attribution 4.0 International License, which permits use, sharing, adaptation, distribution and reproduction in any medium or format, as long as you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons licence, and indicate if changes were made. The images or other third party material in this article are included in the article’s Creative Commons licence, unless indicated otherwise in a credit line to the material. If material is not included in the article’s Creative Commons licence and your intended use is not permitted by statutory regulation or exceeds the permitted use, you will need to obtain permission directly from the copyright holder. To view a copy of this licence, visit http://creativecommons.org/licenses/by/4.0/ (https://creativecommons.org/licenses/by/4.0/) . The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/ (https://creativecommons.org/publicdomain/zero/1.0/) ) applies to the data made available in this article, unless otherwise stated in a credit line to the data. |
spellingShingle | Research Article Dizon, Brian L.P. Redmond, Christopher Gotschlich, Emily C. Sule, Sangeeta Ronis, Tova Vazzana, Kathleen M. Sherman, Matthew A. Connor, Rachael Bosk, Abigail Dham, Niti Harahsheh, Ashraf S. Wells, Elizabeth DeBiasi, Roberta Srinivasalu, Hemalatha Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title | Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title_full | Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title_fullStr | Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title_full_unstemmed | Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title_short | Clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
title_sort | clinical outcomes and safety of anakinra in the treatment of multisystem inflammatory syndrome in children: a single center observational study |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC10388456/ https://www.ncbi.nlm.nih.gov/pubmed/37525200 http://dx.doi.org/10.1186/s12969-023-00858-z |
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