Abstract | BACKGROUND: METHODS: We selected 18 patients with neonatal-onset multisystem inflammatory disease (12 with identifiable CIAS1 mutations) to receive anakinra, an interleukin-1-receptor antagonist (1 to 2 mg per kilogram of body weight per day subcutaneously). In 11 patients, anakinra was withdrawn at three months until a flare occurred. The primary end points included changes in scores in a daily diary of symptoms, serum levels of amyloid A and C-reactive protein, and the erythrocyte sedimentation rate from baseline to month 3 and from month 3 until a disease flare. RESULTS: All 18 patients had a rapid response to anakinra, with disappearance of rash. Diary scores improved (P<0.001) and serum amyloid A (from a median of 174 mg to 8 mg per liter), C-reactive protein (from a median of 5.29 mg to 0.34 mg per deciliter), and the erythrocyte sedimentation rate decreased at month 3 (all P<0.001), and remained low at month 6. Magnetic resonance imaging showed improvement in cochlear and leptomeningeal lesions as compared with baseline. Withdrawal of anakinra uniformly resulted in relapse within days; retreatment led to rapid improvement. There were no drug-related serious adverse events. CONCLUSIONS:
|
Authors | Raphaela Goldbach-Mansky, Natalie J Dailey, Scott W Canna, Ana Gelabert, Janet Jones, Benjamin I Rubin, H Jeffrey Kim, Carmen Brewer, Christopher Zalewski, Edythe Wiggs, Suvimol Hill, Maria L Turner, Barbara I Karp, Ivona Aksentijevich, Frank Pucino, Scott R Penzak, Margje H Haverkamp, Leonard Stein, Barbara S Adams, Terry L Moore, Robert C Fuhlbrigge, Bracha Shaham, James N Jarvis, Kathleen O'Neil, Richard K Vehe, Laurie O Beitz, Gregory Gardner, William P Hannan, Robert W Warren, William Horn, Joe L Cole, Scott M Paul, Philip N Hawkins, Tuyet Hang Pham, Christopher Snyder, Robert A Wesley, Steven C Hoffmann, Steven M Holland, John A Butman, Daniel L Kastner |
Journal | The New England journal of medicine
(N Engl J Med)
Vol. 355
Issue 6
Pg. 581-92
(Aug 10 2006)
ISSN: 1533-4406 [Electronic] United States |
PMID | 16899778
(Publication Type: Journal Article, Research Support, N.I.H., Intramural)
|
Copyright | Copyright 2006 Massachusetts Medical Society. |
Chemical References |
- Carrier Proteins
- IL1RN protein, human
- Interleukin 1 Receptor Antagonist Protein
- NLR Family, Pyrin Domain-Containing 3 Protein
- NLRP3 protein, human
- Receptors, Interleukin-1
- Sialoglycoproteins
|
Topics |
- Adolescent
- Adult
- Carrier Proteins
(genetics)
- Child
- Child, Preschool
- Female
- Hearing Loss
(drug therapy)
- Humans
- Inflammation
(drug therapy, genetics)
- Intellectual Disability
- Interleukin 1 Receptor Antagonist Protein
- Male
- Meningitis
(drug therapy)
- Mutation
- NLR Family, Pyrin Domain-Containing 3 Protein
- Papilledema
(drug therapy)
- Receptors, Interleukin-1
(antagonists & inhibitors)
- Sialoglycoproteins
(adverse effects, therapeutic use)
- Syndrome
- Urticaria
(drug therapy)
|
|
Join CureHunter, for free Research Interface BASIC access!
Take advantage of free CureHunter research engine access to explore the best drug and treatment options for any disease.
Find out why thousands of doctors, pharma researchers and patient activists
around the world use CureHunter every day.
Realize the full power of the drug-disease research graph!
|