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Title:
Tolerance and efficacy of off-label anti-interleukin-1 treatments in France: a nationwide survey | Orphanet Journal of Rare Diseases
Description:
Background Despite their limited licensed indications, antiâinterleukin-1 (antiâIL-1) agents are often used in clinical practice for an increasing number of auto-inflammatory diseases. We conducted a national cross-sectional observational study from January 2011 to January 2013 to record the off-label use of such agents in France. We aimed to estimate the off-label use of antiâIL-1 treatments in France, assess their efficacy in rare diseases, and increase the reporting of their possible side effects. Methods Physicians answered a questionnaire that covered patient and disease data, antiâIL-1 agent use, efficacy and adverse events. The study involved adult or paediatric patient who had received an antiâIL-1 agent after January 2005 in France. Results In total, 189 patients from 38 centres were included. The main diseases were adult-onset Stillâs disease (AOSD) (35), gout (28), systemic juvenile idiopathic arthritis (27), cryopyrin-associated periodic syndrome (CAPS) (21), familial Mediterranean fever (14) and mevalonate kinase deficiency (12). The main off-label used agent was anakinra, used at least once for 185 patients, with canakinumab used for 25. Anakinra was effective in most patients (90%), with higher complete clinical response rates for Schnitzlerâs syndrome, gout, CAPS and AOSD. Overall, 58% of patients showed at least one adverse event, mainly minor injection-site reactions. The main reported serious adverse event was severe infection. Injection-site reactions and liver toxicity were significantly more frequent in children than adults. The main non-cutaneous adverse event was liver toxicity, significantly associated with treatment duration. Weight gain was reported in about 10% of patients and was associated with treatment duration and CAPS. Canakinumab was rarely used and showed better cutaneous tolerance than anakinra but similar rates of non-cutaneous and severe adverse events. Conclusions Anakinra was well tolerated and effective in most patients with various inflammatory diseases. The main adverse events were mild injection-site reactions, especially in children. The survey allowed for collecting limited information on the off-label use of canakinumab.
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Keywords {đ}
patients, anakinra, treatment, article, pubmed, disease, table, google, scholar, diseases, arthritis, antiil, syndrome, canakinumab, efficacy, duration, received, aes, study, clinical, reported, cas, response, data, children, sjia, tolerance, liver, risk, adult, patient, paediatric, weight, information, autoinflammatory, severe, adults, association, analysis, main, france, gain, rheum, offlabel, gout, complete, rare, adverse, aosd, caps,
Topics {âïž}
eu/docs/en_gb/document_library/epar_-_product_information/human/000363/wc500042310 eu/docs/en_gb/document_library/epar_-_product_information/human/001109/wc500031680 universitĂ© lille nord-de-france kuemmerle-deschner jb retrospective cross-sectional design article download pdf real-life clinical practice multi-factorial autoinflammatory diseases auto-immune diseases treated il-1-mediated autoinflammatory diseases autoinflammatory muckle-wells syndrome article rossi-semerano il-1r inhibitor anakinra interleukin-1-receptor antagonist anakinra maladies auto-inflammatoires sequential placebo-controlled studies minor injection-site reactions national reference centre mild injection-site reaction mild injection-site reactions antiâil-1 treatments anakinra label anti-interleukin-1 treatments nlrp12-asociated periodic syndrome antiâil-1 treatment included label antiâil-1 agent antiâil-1 treatment duration linda rossi-semerano 3-year open-label follow long-term anakinra treatment il-36 receptor antagonist antiâil-1 treatment anakinra generalized pustular psoriasis interleukin-1-receptor antagonist interleukin-1 receptor antagonist privacy choices/manage cookies antiâil-1 treatment efficacy auto-inflammatory diseases isabelle konĂ©-paut behrens em open access license made substantial contributions inflammatory biological markers antiâil-1 treatments full access european medicines agency label search search familial mediterranean fever antiâil-1 drugs mas successfully treated interleukin-1 mediated diseases
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headline:Tolerance and efficacy of off-label anti-interleukin-1 treatments in France: a nationwide survey
description:Despite their limited licensed indications, antiâinterleukin-1 (antiâIL-1) agents are often used in clinical practice for an increasing number of auto-inflammatory diseases. We conducted a national cross-sectional observational study from January 2011 to January 2013 to record the off-label use of such agents in France. We aimed to estimate the off-label use of antiâIL-1 treatments in France, assess their efficacy in rare diseases, and increase the reporting of their possible side effects. Physicians answered a questionnaire that covered patient and disease data, antiâIL-1 agent use, efficacy and adverse events. The study involved adult or paediatric patient who had received an antiâIL-1 agent after January 2005 in France. In total, 189 patients from 38 centres were included. The main diseases were adult-onset Stillâs disease (AOSD) (35), gout (28), systemic juvenile idiopathic arthritis (27), cryopyrin-associated periodic syndrome (CAPS) (21), familial Mediterranean fever (14) and mevalonate kinase deficiency (12). The main off-label used agent was anakinra, used at least once for 185 patients, with canakinumab used for 25. Anakinra was effective in most patients (90%), with higher complete clinical response rates for Schnitzlerâs syndrome, gout, CAPS and AOSD. Overall, 58% of patients showed at least one adverse event, mainly minor injection-site reactions. The main reported serious adverse event was severe infection. Injection-site reactions and liver toxicity were significantly more frequent in children than adults. The main non-cutaneous adverse event was liver toxicity, significantly associated with treatment duration. Weight gain was reported in about 10% of patients and was associated with treatment duration and CAPS. Canakinumab was rarely used and showed better cutaneous tolerance than anakinra but similar rates of non-cutaneous and severe adverse events. Anakinra was well tolerated and effective in most patients with various inflammatory diseases. The main adverse events were mild injection-site reactions, especially in children. The survey allowed for collecting limited information on the off-label use of canakinumab.
datePublished:2015-02-15T00:00:00Z
dateModified:2015-02-15T00:00:00Z
pageStart:1
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license:http://creativecommons.org/publicdomain/zero/1.0/
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IL-1
Anakinra
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Tolerance
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Pharmacology/Toxicology
Human Genetics
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headline:Tolerance and efficacy of off-label anti-interleukin-1 treatments in France: a nationwide survey
description:Despite their limited licensed indications, antiâinterleukin-1 (antiâIL-1) agents are often used in clinical practice for an increasing number of auto-inflammatory diseases. We conducted a national cross-sectional observational study from January 2011 to January 2013 to record the off-label use of such agents in France. We aimed to estimate the off-label use of antiâIL-1 treatments in France, assess their efficacy in rare diseases, and increase the reporting of their possible side effects. Physicians answered a questionnaire that covered patient and disease data, antiâIL-1 agent use, efficacy and adverse events. The study involved adult or paediatric patient who had received an antiâIL-1 agent after January 2005 in France. In total, 189 patients from 38 centres were included. The main diseases were adult-onset Stillâs disease (AOSD) (35), gout (28), systemic juvenile idiopathic arthritis (27), cryopyrin-associated periodic syndrome (CAPS) (21), familial Mediterranean fever (14) and mevalonate kinase deficiency (12). The main off-label used agent was anakinra, used at least once for 185 patients, with canakinumab used for 25. Anakinra was effective in most patients (90%), with higher complete clinical response rates for Schnitzlerâs syndrome, gout, CAPS and AOSD. Overall, 58% of patients showed at least one adverse event, mainly minor injection-site reactions. The main reported serious adverse event was severe infection. Injection-site reactions and liver toxicity were significantly more frequent in children than adults. The main non-cutaneous adverse event was liver toxicity, significantly associated with treatment duration. Weight gain was reported in about 10% of patients and was associated with treatment duration and CAPS. Canakinumab was rarely used and showed better cutaneous tolerance than anakinra but similar rates of non-cutaneous and severe adverse events. Anakinra was well tolerated and effective in most patients with various inflammatory diseases. The main adverse events were mild injection-site reactions, especially in children. The survey allowed for collecting limited information on the off-label use of canakinumab.
datePublished:2015-02-15T00:00:00Z
dateModified:2015-02-15T00:00:00Z
pageStart:1
pageEnd:11
license:http://creativecommons.org/publicdomain/zero/1.0/
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Auto-inflammatory diseases
IL-1
Anakinra
Canakinumab
Tolerance
Off-label
Medicine/Public Health
general
Pharmacology/Toxicology
Human Genetics
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name:Department of Paediatric Rheumatology, HĂŽpital de BicĂȘtre, APHP, National Reference Centre for Auto-inflammatory Diseases, Le Kremlin-BicĂȘtre, University of Paris Sud, Le Kremlin, France
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address:
name:Maladies Auto-inflammatoires, Laboratoire de Génétique, HÎpital A de Villeneuve, CHRU Montpellier, Montpellier, France
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name:HĂŽpital de BicĂȘtre, APHP, National Reference Centre for Auto-inflammatory Diseases, Le Kremlin-BicĂȘtre, University of Paris Sud
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name:Department of Paediatric Rheumatology, HĂŽpital de BicĂȘtre, APHP, National Reference Centre for Auto-inflammatory Diseases, Le Kremlin-BicĂȘtre, University of Paris Sud, Le Kremlin, France
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name:Department of Paediatric Rheumatology, HĂŽpital de BicĂȘtre, APHP, National Reference Centre for Auto-inflammatory Diseases, Le Kremlin-BicĂȘtre, University of Paris Sud, Le Kremlin, France
name:Department of Rheumatology, HĂŽpital La PitiĂ© SalpĂȘtriĂšre, APHP; UPMC, GRC 08, Institut Pierre Louis dâEpidĂ©miologie et SantĂ© Publique, Paris, France
name:Department of Rheumatology, University Teaching Hospital, CHRU Besançon, and University of Franche-Comté, Besançon, France
name:Centre de Référence des Maladies Autoimmunes et systémiques Rares, Service de Médecine Interne, HÎpital Claude Huriez, Université Lille Nord-de-France, Lille Cedex, France
name:Department of Paediatric Rheumatology, HĂŽpital de BicĂȘtre, APHP, National Reference Centre for Auto-inflammatory Diseases, Le Kremlin-BicĂȘtre, University of Paris Sud, Le Kremlin, France
name:Department of Rheumatology, HĂŽpital Avicenne, APHP, INSERM UMR 1125, Paris 13 University, Bobigny, France
name:Maladies Auto-inflammatoires, Laboratoire de Génétique, HÎpital A de Villeneuve, CHRU Montpellier, Montpellier, France
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