Case Report

Effective Use of the Recombinant Interleukin 1 Receptor Antagonist Anakinra in Therapy Resistant Systemic Onset Juvenile Rheumatoid Arthritis

JAMES W. VERBSKY and ANDREW J. WHITE

ABSTRACT.

Systemic onset juvenile rheumatoid arthritis (SOJRA) is a multisystem disease characterized by high fever, rash, arthritis, serositis, splenomegaly, and laboratory evidence of systemic inflammation. Anticytokine therapies show promise in the treatment of chronic arthritides in children. We describe the use of the recombinant interleukin 1 receptor antagonist anakinra in 2 patients with therapy resistant SOJRA. Both patients experienced immediate and sustained resolution of symptoms and laboratory markers of inflammation, in one case after years of treatment with other immunosuppressive therapies. (J Rheumatol 2004;31:2071-5)

Key Indexing Terms:

JUVENILE ONSET STILL DISEASE
ANAKINRA
INFLIXIMAB
HEMOPHAGOCYTIC SYNDROME
JUVENILE RHEUMATOID ARTHRITIS

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From the Division of Rheumatology, Department of Pediatrics, Washington University School of Medicine and St. Louis Children's Hospital, St. Louis, Missouri, USA.

J.W. Verbsky was supported by a Pediatrician Physician-Scientist Training Grant (NIH-T32 HDO43010).

A.J. White, MD, MSc, Assistant Professor in Pediatrics, Division of Pediatric Immunology and Rheumatology, Department of Pediatrics; J.W. Verbsky, MD, PhD, Fellow in Pediatric Immunology and Rheumatology, Department of Pediatrics.

Address reprint requests to Dr. A.J. White, St. Louis Children's Hospital, One Children's Place, Room 1000, St. Louis, MO 63110. E-mail: white@kids.wustl.edu

Submitted June 17, 2003; revision accepted April 26, 2004.

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