Treatment of systemic idiopathic juvenile arthritis with monoclonal antibody
Systemic juvenile idiopathic arthritis (SJIA), the most severe JIA subtype, is characterized by chronic arthritis; intermittently high, spiking temperatures; maculopapular rash; hepatosplenomegaly; lymphadenopathy; serositis; and a marked increase in the level of acute-phase reactants.
Complications of systemic JIA include growth impairment, osteoporosis, and the potentially lethal macrophage activation syndrome. SJIA is heterogeneous in nature, and the disease course can vary from patient to patient in terms of severity and outcomes.
In this review, researchers revealed canakinumab, a new medication approved for treatment of systemic juvenile idiopathic arthritis. It is a fully human, anti–interleukin-1β monoclonal antibody that selectively binds to interleukin-1β, inactivating its signaling. For this, they reviewed the data which supports canakinumab in SJIA patients and compared to other available biologic medications.
They assessed phase II and phase III trials and provides an overview of the chemical composition of canakinumab that led to approval for treatment of active SJIA. In order to undertake this review, literature search has been performed by authors using Pubmed, with keywords 'canakinumab,' 'biologic,' 'anti-IL-1B,' and systemic juvenile idiopathic arthritis, focusing on publications within the last 5 years.
Research has shown that canakinumab is effective in SJIA treatment with active systemic features including fever. However, there is no evidence that argue to suggest increased risk of macrophage activation syndrome. Although, canakinumab for the treatment of chronic arthritis without active systemic features has not been approved yet, but it warrants further investigation.