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Drugs Hold Promise for Severe Juvenile Arthritis Patients
Date:12/20/2012

By Mary Brophy Marcus
HealthDay Reporter

WEDNESDAY, Dec. 19 (HealthDay News) -- Children who suffer from a rare and painful form of arthritis that's accompanied by fever and rashes may soon have more treatment options.

Two studies published in the Dec. 20 issue of the New England Journal of Medicine suggest that two drugs -- canakinumab and tocilizumab -- reduce symptoms, including severe joint pain experienced by children with systemic juvenile idiopathic arthritis (JIA).

"Systemic juvenile idiopathic arthritis is a form of severe arthritis which until a few years ago was treated mainly with corticosteroids which have known side effects, especially growth impairment," said Dr. Nicolino Ruperto, a pediatric rheumatologist at G. Gaslini Children's Hospital in Genoa and co-author of the studies. The research looked at the safety and effectiveness of the interleukin-1 inhibitor canakinumab and the interleukin-6 inhibitor tocilizumab.

The disease is one of seven types of juvenile idiopathic arthritis that affect one in 1,000, or roughly 294,000, children in the United States, according to the U.S. National Institutes of Health. It is characterized by inflammation of one or more joints, fever and rash, among other health problems. "Idiopathic" means the cause is unknown.

In the canakinumab study, funded by drug maker Novartis Pharma, two trials took place. In one, patients received the drug subcutaneously (injected just below the skin) or a placebo. In the other, canakinumab was taken knowingly, or open-label.

"The study demonstrated that among 190 children with systemic JIA, about 60 percent of the children treated for several months had a complete disappearance of both arthritis, fever and rash," said Ruperto. One-third also discontinued corticosteroids, he said.

Ruperto said canakinumab works by reducing the level of a cytokine (a protein) called interleukin-1 that leads to the inflamma
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