Macrophage activation syndrome in patients with systemic juvenile idiopathic arthritis on anti-interleukin-1 or -6 therapy.
| Title: | Macrophage activation syndrome in patients with systemic juvenile idiopathic arthritis on anti-interleukin-1 or -6 therapy. |
|---|---|
| Authors: | Ulu K; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey.; Aliyev E; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.; Kılıç Könte E; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey.; Tanatar A; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey.; Türkmen Ş; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey.; Doğantan Ş; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey.; Kızıldağ Z; Department of Pediatric Rheumatology, Dokuz Eylül University, İzmir, Turkey.; Kasap Demir B; Department of Pediatric Rheumatology, Tepecik Training and Research Hospital, İzmir, Turkey.; Gezgin Yıldırım D; Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey.; Otar Yener G; Department of Pediatric Rheumatology, Gaziantep Medical Point Hospital, Gaziantep, Turkey.; Öztürk K; Department of Pediatric Rheumatology, İstanbul Medeniyet University, İstanbul, Turkey.; Baba Ö; Department of Pediatric Rheumatology, Karadeniz Technical University, Trabzon, Turkey.; Açarı C; Department of Pediatric Rheumatology, İnönü University, Malatya, Turkey.; Kılbaş G; Department of Pediatric Rheumatology, Pamukkale University, Denizli, Turkey.; Taşkın SN; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey.; Haşlak F; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey.; Çağlayan Ş; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey.; Bağlan E; Department of Pediatric Rheumatology, Dr Sami Ulus Maternity and Child Health and Diseases Training and Research Hospital, Ankara, Turkey.; Dundar HA; Department of Pediatric Rheumatology, Van Training and Research Hospital, Van, Turkey.; Başaran Ö; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.; Barut K; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey.; Karadağ ŞG; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey.; Coşkuner T; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey.; Sönmez HE; Department of Pediatric Rheumatology, Kocaeli University, Kocaeli, Turkey.; Yüksel S; Department of Pediatric Rheumatology, Pamukkale University, Denizli, Turkey.; Kalyoncu M; Department of Pediatric Rheumatology, Karadeniz Technical University, Trabzon, Turkey.; Bakkaloğlu SA; Department of Pediatric Rheumatology, Gazi University, Ankara, Turkey.; Ünsal E; Department of Pediatric Rheumatology, Dokuz Eylül University, İzmir, Turkey.; Paç Kısaarslan A; Department of Pediatric Rheumatology, Erciyes University, Kayseri, Turkey.; Bilginer Y; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.; Aktay Ayaz N; Department of Pediatric Rheumatology, İstanbul University, İstanbul, Turkey.; Kasapçopur Ö; Department of Pediatric Rheumatology, İstanbul University-Cerrahpasa, İstanbul, Turkey.; Özen S; Department of Pediatric Rheumatology, Hacettepe University, Ankara, Turkey.; Sözeri B; Department of Pediatric Rheumatology, Ümraniye Training and Research Hospital, İstanbul, Turkey. |
| Source: | Rheumatology (Oxford, England) [Rheumatology (Oxford)] 2024 Sep 01; Vol. 63 (SI2), pp. SI167-SI172. |
| Publication Type: | Journal Article; Multicenter Study |
| Language: | English |
| Journal Info: | Publisher: Oxford University Press Country of Publication: England NLM ID: 100883501 Publication Model: Print Cited Medium: Internet ISSN: 1462-0332 (Electronic) Linking ISSN: 14620324 NLM ISO Abbreviation: Rheumatology (Oxford) Subsets: MEDLINE |
| Imprint Name(s): | Original Publication: Oxford, UK : Avenel, N.J. : Oxford University Press ; Distributed by Mercury International, c1999- |
| MeSH Terms: | Macrophage Activation Syndrome*/etiology ; Macrophage Activation Syndrome*/drug therapy ; Arthritis, Juvenile*/drug therapy ; Arthritis, Juvenile*/complications ; Antibodies, Monoclonal, Humanized*/therapeutic use; Antirheumatic Agents/therapeutic use ; Interleukin-6/blood ; Interleukin-1/antagonists & inhibitors ; C-Reactive Protein/metabolism ; C-Reactive Protein/analysis ; Biological Products/therapeutic use ; Ferritins/blood ; Humans ; Male ; Female ; Child ; Child, Preschool ; Adolescent ; Blood Sedimentation ; Platelet Count ; Interleukin-6 Inhibitors |
| Abstract: | Objectives: The aim of this study is to investigate the effect of anti-interleukin (IL)-1/-6 biologics on systemic juvenile idiopathic arthritis (sJIA)-associated macrophage activation syndrome (MAS).; Methods: Demographic, clinical and laboratory data of patients followed up with a diagnosis of sJIA-associated MAS assessed from sixteen paediatric rheumatology centres across the country. The clinical and laboratory features of MAS developing while on biological drugs were compared with those without this treatment.; Results: One hundred and sixty-two patients were included in the study. Forty-five of the MAS events were detected under the effect of anti-IL-1/-6 biologics, while the patients experiencing the remaining 155 events have not received biological treatment in the last three months. Platelet count [128 (72-232) vs 199 (130-371) 109/l], ferritin level on admission [1107 (676-2050) vs 2863 (1193-9562) ng/ml], C-reactive protein level [15.4 (2.9-56) vs 90 (32-160) mg/l], erythrocyte sedimentation rate [13 (3-36) vs 43.5 (13-77) mm/h] and fever duration [5 (4-7.5) vs 10 (7-14.3) days] were found lower in the group under the impact of anti-IL-1/-6 biologics. Among patients treated with biologics, 26.6% did not meet the published 2016 MAS classification criteria at presentation. The rates of hepatomegaly and splenomegaly were relatively lower in the canakinumab-treated group when compared with those receiving other biologicals or to patients, not on biologicals.; Conclusion: Anti-IL-1/-6 therapies can mask the clinical and laboratory features of MAS, and proposed guidelines for MAS classification criteria may not be met.; (© The Author(s) 2024. Published by Oxford University Press on behalf of the British Society for Rheumatology. All rights reserved. For permissions, please email: journals.permissions@oup.com.) |
| Contributed Indexing: | Keywords: anakinra; anti-interleukin-1; anti-interleukin-6; biological drugs; canakinumab; macrophage activation syndrome; tocilizumab |
| Substance Nomenclature: | 0 (Antibodies, Monoclonal, Humanized); 0 (Antirheumatic Agents); 0 (Interleukin-6); 0 (Interleukin-1); 9007-41-4 (C-Reactive Protein); 0 (Biological Products); 9007-73-2 (Ferritins); 0 (Interleukin-6 Inhibitors); 37CQ2C7X93 (canakinumab) |
| Entry Date(s): | Date Created: 20240305 Date Completed: 20240909 Latest Revision: 20260127 |
| Update Code: | 20260130 |
| DOI: | 10.1093/rheumatology/keae124 |
| PMID: | 38441301 |
| Database: | MEDLINE |
Journal Article; Multicenter Study