{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,1]],"date-time":"2026-10-01T09:36:39Z","timestamp":1790847399553,"version":"4.1.0"},"reference-count":40,"publisher":"Wiley","issue":"7","license":[{"start":{"date-parts":[[2019,5,25]],"date-time":"2019-05-25T00:00:00Z","timestamp":1558742400000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by-nc\/4.0\/"}],"funder":[{"DOI":"10.13039\/100011272","name":"FP7 Health","doi-asserted-by":"publisher","award":["FP7\/2007\u20102013, EC\u2010GA No. 305266 \u2018MIAMI\u2019"],"award-info":[{"award-number":["FP7\/2007\u20102013, EC\u2010GA No. 305266 \u2018MIAMI\u2019"]}],"id":[{"id":"10.13039\/100011272","id-type":"DOI","asserted-by":"publisher"}]}],"content-domain":{"domain":["acrjournals.onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Arthritis &amp; Rheumatology"],"published-print":{"date-parts":[[2019,7]]},"abstract":"<jats:sec><jats:title>Objective<\/jats:title><jats:p>Systemic juvenile idiopathic arthritis (JIA) is a multifactorial autoinflammatory disease with a historically poor prognosis. With current treatment regimens, approximately half of patients still experience active disease after 1 year of therapy. This study was undertaken to evaluate a treat\u2010to\u2010target approach using recombinant interleukin\u20101 receptor antagonist (rIL\u20101Ra; anakinra) as first\u2010line monotherapy to achieve early inactive disease and prevent damage.<\/jats:p><\/jats:sec><jats:sec><jats:title>Methods<\/jats:title><jats:p>In this single\u2010center, prospective study, patients with new\u2010onset systemic JIA with an unsatisfactory response to nonsteroidal antiinflammatory drugs received rIL\u20101Ra monotherapy according to a treat\u2010to\u2010target strategy. Patients with an incomplete response to 2 mg\/kg rIL\u20101Ra subsequently received 4 mg\/kg rIL\u20101Ra or additional prednisolone, or switched to alternative therapy. For patients in whom inactive disease was achieved, rIL\u20101Ra was tapered after 3 months and subsequently stopped.<\/jats:p><\/jats:sec><jats:sec><jats:title>Results<\/jats:title><jats:p>Forty\u2010two patients, including 12 who had no arthritis at disease onset, were followed up for a median of 5.8 years. The median time to achieve inactive disease was 33 days. At 1 year, 76% had inactive disease, and 52% had inactive disease while not receiving medication. High neutrophil counts at baseline and a complete response after 1 month of rIL\u20101Ra were highly associated with inactive disease at 1 year. After 5 years of follow\u2010up, 96% of the patients included had inactive disease, and 75% had inactive disease while not receiving medication. Articular or extraarticular damage was reported in &lt;5%, and only 33% of the patients received glucocorticoids. Treatment with rIL\u20101Ra was equally effective in systemic JIA patients without arthritis at disease onset.<\/jats:p><\/jats:sec><jats:sec><jats:title>Conclusion<\/jats:title><jats:p>Treatment to target, starting with first\u2010line, short\u2010course monotherapy with rIL\u20101Ra, is a highly efficacious strategy to induce and sustain inactive disease and to prevent disease\u2010 and glucocorticoid\u2010related damage in systemic JIA.<\/jats:p><\/jats:sec>","DOI":"10.1002\/art.40865","type":"journal-article","created":{"date-parts":[[2019,3,8]],"date-time":"2019-03-08T06:05:34Z","timestamp":1552025134000},"page":"1163-1173","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":174,"title":["Treatment to Target Using Recombinant Interleukin\u20101 Receptor Antagonist as First\u2010Line Monotherapy in New\u2010Onset Systemic Juvenile Idiopathic Arthritis: Results From a Five\u2010Year Follow\u2010Up Study"],"prefix":"10.1002","volume":"71","author":[{"given":"Nienke M.","family":"ter Haar","sequence":"first","affiliation":[{"name":"University Medical Center Utrecht and Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"E. 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H.","family":"de Groot","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht and Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Saskia","family":"Haitjema","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht and Utrecht University  Utrecht The Netherlands"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Holzinger","sequence":"additional","affiliation":[{"name":"University of Munster, Munster, Germany, and University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Dirk","family":"Foell","sequence":"additional","affiliation":[{"name":"University of Duisburg\u2010Essen  Essen Germany"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jorg","family":"van Loosdregt","sequence":"additional","affiliation":[{"name":"University Medical Center Utrecht and Utrecht University  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