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Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety

BACKGROUND: Anakinra is the first interleukin-1 inhibitor to be used in clinical practice, and recent evidence showed that interleukin-1 plays a pivotal role in the pathogenesis of adult-onset Still disease (AoSD). However, data concerning efficacy with anakinra use in different clinical trials has...

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Autores principales: Hong, Dongsheng, Yang, Zhihai, Han, Shuyin, Liang, Xingguang, Ma, Kuifen, Zhang, Xingguo
Formato: Online Artículo Texto
Lenguaje:English
Publicado: Dove Medical Press 2014
Materias:
Acceso en línea:https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251663/
https://www.ncbi.nlm.nih.gov/pubmed/25473268
http://dx.doi.org/10.2147/DDDT.S73428
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author Hong, Dongsheng
Yang, Zhihai
Han, Shuyin
Liang, Xingguang
Ma, Kuifen
Zhang, Xingguo
author_facet Hong, Dongsheng
Yang, Zhihai
Han, Shuyin
Liang, Xingguang
Ma, Kuifen
Zhang, Xingguo
author_sort Hong, Dongsheng
collection PubMed
description BACKGROUND: Anakinra is the first interleukin-1 inhibitor to be used in clinical practice, and recent evidence showed that interleukin-1 plays a pivotal role in the pathogenesis of adult-onset Still disease (AoSD). However, data concerning efficacy with anakinra use in different clinical trials has not been evaluated, and the overall remission of AoSD with anakinra treatment has not been well defined. METHODS: We conducted a search on Embase, PubMed, and the Cochrane Library for relevant trials. Statistical analyses were conducted to calculate the overall remission rates, odds ratios (OR), and 95% confidence intervals (CI), by using either random effects or fixed effect models according to the heterogeneity. RESULTS: Of the 273 articles that were identified, 265 were excluded. Eight studies were eligible for inclusion. The overall remission rate and complete remission rate of anakinra in AoSD patients were 81.66% (95% CI: 69.51%–89.69%) and 66.75% (95% CI: 59.94%–75.3%), respectively. Compared with the controls, the use of anakinra was associated with a significant remission in AoSD, with an OR of 0.16 (95% CI: 0.06–0.44, P=0.0005). There were also significant reductions of the dosage of corticosteroid (mean difference =21.19) (95% CI: 13.2–29.18, P<0.0001) from anakinra onset to the latest follow up time. Clinical and laboratory parameters were all improved, and anakinra was well tolerated in patients with AoSD. No evidence of publication bias was observed. CONCLUSION: Our study has shown that anakinra is effective in remitting the manifestations of AoSD, with reduction of the dose of corticosteroid in patients with AoSD. Further, anakinra therapy was not associated with increased risk of adverse events, and it was well tolerated in patients with AoSD. Further research is still recommended to investigate these findings.
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spelling pubmed-42516632014-12-03 Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety Hong, Dongsheng Yang, Zhihai Han, Shuyin Liang, Xingguang Ma, Kuifen Zhang, Xingguo Drug Des Devel Ther Review BACKGROUND: Anakinra is the first interleukin-1 inhibitor to be used in clinical practice, and recent evidence showed that interleukin-1 plays a pivotal role in the pathogenesis of adult-onset Still disease (AoSD). However, data concerning efficacy with anakinra use in different clinical trials has not been evaluated, and the overall remission of AoSD with anakinra treatment has not been well defined. METHODS: We conducted a search on Embase, PubMed, and the Cochrane Library for relevant trials. Statistical analyses were conducted to calculate the overall remission rates, odds ratios (OR), and 95% confidence intervals (CI), by using either random effects or fixed effect models according to the heterogeneity. RESULTS: Of the 273 articles that were identified, 265 were excluded. Eight studies were eligible for inclusion. The overall remission rate and complete remission rate of anakinra in AoSD patients were 81.66% (95% CI: 69.51%–89.69%) and 66.75% (95% CI: 59.94%–75.3%), respectively. Compared with the controls, the use of anakinra was associated with a significant remission in AoSD, with an OR of 0.16 (95% CI: 0.06–0.44, P=0.0005). There were also significant reductions of the dosage of corticosteroid (mean difference =21.19) (95% CI: 13.2–29.18, P<0.0001) from anakinra onset to the latest follow up time. Clinical and laboratory parameters were all improved, and anakinra was well tolerated in patients with AoSD. No evidence of publication bias was observed. CONCLUSION: Our study has shown that anakinra is effective in remitting the manifestations of AoSD, with reduction of the dose of corticosteroid in patients with AoSD. Further, anakinra therapy was not associated with increased risk of adverse events, and it was well tolerated in patients with AoSD. Further research is still recommended to investigate these findings. Dove Medical Press 2014-11-25 /pmc/articles/PMC4251663/ /pubmed/25473268 http://dx.doi.org/10.2147/DDDT.S73428 Text en © 2014 Hong et al. This work is published by Dove Medical Press Limited, and licensed under Creative Commons Attribution – Non Commercial (unported, v3.0) License The full terms of the License are available at http://creativecommons.org/licenses/by-nc/3.0/. Non-commercial uses of the work are permitted without any further permission from Dove Medical Press Limited, provided the work is properly attributed.
spellingShingle Review
Hong, Dongsheng
Yang, Zhihai
Han, Shuyin
Liang, Xingguang
Ma, Kuifen
Zhang, Xingguo
Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title_full Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title_fullStr Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title_full_unstemmed Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title_short Interleukin 1 inhibition with anakinra in adult-onset Still disease: a meta-analysis of its efficacy and safety
title_sort interleukin 1 inhibition with anakinra in adult-onset still disease: a meta-analysis of its efficacy and safety
topic Review
url https://www.ncbi.nlm.nih.gov/pmc/articles/PMC4251663/
https://www.ncbi.nlm.nih.gov/pubmed/25473268
http://dx.doi.org/10.2147/DDDT.S73428
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