A treat-to-target approach using recombinant IL-1 receptor antagonist (rIL-1Ra; anakinra) as a first-line monotherapy in newly diagnosed patients with systemic juvenile idiopathic arthritis (sJIA; n = 42) resulted in inactive disease in 95% of patients and inactive disease (off medication) in 73% of patients at 5 years follow-up. The treat-to-target strategy involved rapidly stepping up the dose of rIL-1Ra from 2 mg/kg/day to 4 mg/kg/day if fever persisted 3 days after starting therapy, followed by the addition of glucocorticoids and/or switching to an alternative therapy if disease persisted.
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ter Haar, N. M. et al. Treat-to-target using first-line recombinant interleukin-1 receptor antagonist monotherapy in new-onset systemic juvenile idiopathic arthritis: results from a five year follow-up study. Arthritis Rheumatol. https://doi.org/10.1002/art.40865 (2019)
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Collison, J. Recombinant IL-1Ra as first-line therapy in sJIA. Nat Rev Rheumatol 15, 250 (2019). https://doi.org/10.1038/s41584-019-0208-8
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DOI: https://doi.org/10.1038/s41584-019-0208-8