- Oral presentation
- Open Access
Recombinant IL1-RA in the early phase of systemic onset JIA: before the onset of arthritis
© Vastert et al; licensee BioMed Central Ltd. 2011
- Published: 14 September 2011
- Systemic Inflammation
- Radiological Evaluation
Systemic Onset Juvenile Idiopathic Arthritis (SoJIA) is characterized by systemic inflammation besides arthritis. SoJIA has a broad differential diagnosis. In a minority of SoJIA patients, it takes time (weeks to months) before arthritis develops. These cases are challenging for clinicians, as is the question how and when to treat these patients.
to identify SoJIA patients before the onset of arthritis and to evaluate treatment with recombinant IL-1RA (Anakinra) in these ‘suspected SoJIA’ patients.
We characterized the systemic inflammation in 5 ´suspected SoJIA´ patients and compared them to our cohort of known SoJIA patients. These 5 patients were thoroughly checked for alternative diagnoses by extensive microbial analysis (PCR, cultures), radiological evaluation (including CT and/or PET scans) and genetic testing where appropriate. Moreover, bonemarrow aspirates were performed to rule out leukemia and haemophagocytosis.
Biochemical and immunological parameters of disease activity (ESR, CRP, Ferritin) as well as newly developed biomarkers for SoJIA (cytokine profiles (IL-18), MRPÂ´s, NK cell numbers, phenotype and lytic function) were assessed at onset of disease and during treatment with Anakinra.
Suspected SoJIA patients (without arthritis, n=5)
SoJIA cohort Utrecht (n=15)
IL-18 plasma (ng/L)
Abs. NK cell (x109/L)
NK cell function (% killing)
Here we show that, making use of recently developed biomarkers, `suspected SoJIA´ patients can be identified very early in their disease-course, before the development of arthritis. These patients show a similar beneficial clinical response to treatment with recombinant IL-1RA as our cohort of newly diagnosed SoJIA patients. Our data support the idea of early treatment with recombinant IL-1RA in (suspected) SoJIA patients.
This article is published under license to BioMed Central Ltd. This is an open access article distributed under the terms of the Creative Commons Attribution License (http://creativecommons.org/licenses/by/2.0), which permits unrestricted use, distribution, and reproduction in any medium, provided the original work is properly cited.