Session Information
The 2020 Pediatric Rheumatology Symposium, originally scheduled for April 29 – May 2, was postponed due to COVID-19; therefore, abstracts were not presented as scheduled.
Date: Saturday, May 2, 2020
Session Title: Poster Session 3
Session Type: ACR Abstract Session
Session Time: 4:15PM-5:15PM
Background/Purpose: Most, but not all, patients with systemic juvenile idiopathic arthritis (systemic JIA) respond to therapy with interleukin (IL)-1 blocking agents but predictive factors have not been clearly established. We have previously observed a correlation between serum levels of IL-18, interferon (IFN)-γ and CXCL9 at onset of therapy with response to canakinumab therapy in a prospective, well-characterized cohort (1). The purpose of this study was to analyze this relationship in a real-world cohort.
Methods: We analyzed patients with systemic JIA enrolled in the German autoinflammatory disease (AID) registry’s biobank who were treated with IL-1 blocking agents (either anakinra or canakinumab), and for whom serum samples and outcome data were available. Different outcomes were assessed, including persistent response to IL-1 blockade (no future switch to IL-6 blockade), any improvement, and achievement of clinical inactive disease within 6 months of IL-1 blockade. We analyzed first available serum samples in the biobank via Luminex multiplex assay for IL-18, IFN-γ and CXCL9.
Results: Seventy-eight patients were studied, of whom 62 (79%) were persistent responders, 72 (92%) any responders, and 39 (50%) in CID within 6 months. Twenty-eight (36%) of samples were drawn at a time of active disease. Non-parametric testing showed that persistent responders v. not persistent responders had lower CXCL-9 levels (p< 0.01) and higher IFN-γ:CXCL9 ratios (p< 0.01). Similar findings were seen for any responders v. non-responders (lower CXCL9 levels [p=0.02], higher CXCL-9:IL-18 [p=0.02] as well as IFN-γ:CXCL9 ratios [p< 0.01]) and for CID within 6 months v. not (IL-18:CXCL9-ratios [p=0.04]).
Conclusion: This study of a real-world cohort of patients with systemic JIA supports the notion that there is an impact of dysregulation of the IL-18-IFN-γ-CXCL9 axis on response to therapy with IL-1 blocking agents.
References:
(1) Hinze T, Kessel C, Hinze C, Seibert J, Gram H, Foell D. Multiplex Serum Biomarker Analysis before and during Therapy with Canakinumab in Patients with Systemic Juvenile Idiopathic Arthritis [abstract]. Arthritis Rheumatol. 2018; 70 (suppl 10);
To cite this abstract in AMA style:
Hinze C, Hinze T, Wittkowski H, Kessel C, Fuehner S, Foell D. Serum Biomarkers in a German Cohort of Patients with Systemic Juvenile Idiopathic Arthritis and Their Relationship to Response to Interleukin-1 Blockade [abstract]. Arthritis Rheumatol. 2020; 72 (suppl 4). https://acrabstracts.org/abstract/serum-biomarkers-in-a-german-cohort-of-patients-with-systemic-juvenile-idiopathic-arthritis-and-their-relationship-to-response-to-interleukin-1-blockade/. Accessed December 3, 2022.« Back to 2020 Pediatric Rheumatology Symposium
ACR Meeting Abstracts - https://acrabstracts.org/abstract/serum-biomarkers-in-a-german-cohort-of-patients-with-systemic-juvenile-idiopathic-arthritis-and-their-relationship-to-response-to-interleukin-1-blockade/