A new interleukin-1 (IL-1)-beta blocking monoclonal antibody, Canakinumab (ACZ885), holds enough promise suggesting efficacy and toleration in children with systemic juvenile idiopathic arthritis (sJIA), as per a new phase II study presented at PReS 2009, a joint congress with the 2009 Congress of the European League against Rheumatism (EULAR) in Copenhagen, Denmark.

Dr Nicolino Ruperto, Senior Scientist of Paediatric Rheumatology International Trials Organization, Istituto Di Ricovero a Carattere Scientifico (IRCCS) Children’s Hospital of Genova, Italy and study’s lead author, remarked that juvenile idiopathic arthritis is the most common of all chronic inflammatory diseases of childhood and sJIA is the most severe subtype.

From Sciencedaily.com:

The observed time to relapse upon cessation of canakinumab therapy was variable, ranging from 1-12 weeks. The time to relapse was analysed using a frailty model with dose grouping - this included statistically significant baseline covariates such as CRP, WBC (white blood cell) count and steroid dose. The median time to relapse was 56 (95% CI: 32-100), 60 (38-95) and 90 (45-181) days for doses <3, 3, >3 mg/kg, with a 19% (95% CI: 6-41), 17% (6-34) and 7% (1-23) probability of relapse within one month, respectively.

Concurrent steroid use was tapered in 70% of responders. On average, the steroid dose was decreased by an average of 0.054 mg/kg per month in the first 5 months (95% CI: 0.013-0.121). Adverse events experienced by study participants were predominantly mild to moderate in severity, including infections and gastrointestinal disorders. Two serious adverse events (worsening nausea in a patient with a medical history of gastritis and EBV viral infection in another patient) relating to canakinumab, according to the investigator, were resolved during treatment.

It was noted by Dr. Ruperto that canakinumab has the potential to be an effective and fast treatment option besides boasting of a promising safety profile.