{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T14:12:46Z","timestamp":1776262366743,"version":"3.50.1"},"reference-count":15,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T00:00:00Z","timestamp":1776211200000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Pediatr."],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>Chronic inflammatory diseases in children can involve distinct immunologic pathways, occasionally necessitating dual biologic therapy when single-agent treatment is insufficient. Evidence on combined IL-1 and TNF-\u03b1 inhibition remains limited.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Cases<\/jats:title>\n                    <jats:p>A 15-year-old girl with ulcerative colitis and recurrent pericarditis received adalimumab and anakinra, achieving clinical remission without infections over eight months. An 11-year-old boy with juvenile idiopathic arthritis, uveitis, and colchicine-resistant familial Mediterranean fever received combined adalimumab and anakinra, achieving low disease activity in both conditions at six months, without adverse events.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Discussion<\/jats:title>\n                    <jats:p>Dual blockade of TNF-\u03b1 and IL-1 may be rational in selected patients due to overlapping and complementary roles of these cytokines in driving inflammation. Our cases illustrate that this combination can be effective and well tolerated with careful monitoring.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>In carefully selected pediatric patients, simultaneous TNF-\u03b1 and IL-1 inhibition may provide clinical benefit. Further studies are required to assess long-term safety and efficacy.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fped.2026.1713890","type":"journal-article","created":{"date-parts":[[2026,4,15]],"date-time":"2026-04-15T13:24:02Z","timestamp":1776259442000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Case Report: Safety and efficacy of combination therapy with adalimumab and anakinra in two patients with severe inflammatory diseases"],"prefix":"10.3389","volume":"14","author":[{"given":"Simone","family":"Coslovich","sequence":"first","affiliation":[{"name":"Department of Medicine, Surgery, and Health Sciences, University of Trieste","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Matteo","family":"Bramuzzo","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Serena","family":"Pastore","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Daniela","family":"Chicco","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Sara","family":"Lega","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Giulia","family":"Gortani","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Thomas","family":"Caiffa","sequence":"additional","affiliation":[{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Alberto","family":"Tommasini","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Health Sciences, University of Trieste","place":["Trieste, Italy"]},{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Andrea","family":"Taddio","sequence":"additional","affiliation":[{"name":"Department of Medicine, Surgery, and Health Sciences, University of Trieste","place":["Trieste, Italy"]},{"name":"Institute for Maternal and Child Health, IRCCS \u201cBurlo Garofolo\u201d","place":["Trieste, Italy"]}],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"1965","published-online":{"date-parts":[[2026,4,15]]},"reference":[{"key":"B1","doi-asserted-by":"publisher","first-page":"4488","DOI":"10.1172\/JCI90699","article-title":"TNF regulates transcription of NLRP3 inflammasome components and inflammatory molecules in cryopyrinopathies","volume":"127","author":"McGeough","year":"2017","journal-title":"J Clin Invest"},{"key":"B2","doi-asserted-by":"publisher","first-page":"8","DOI":"10.1111\/imr.12621","article-title":"Overview of the IL-1 family in innate inflammation and acquired immunity","volume":"281","author":"Dinarello","year":"2018","journal-title":"Immunol Rev"},{"key":"B3","doi-asserted-by":"publisher","first-page":"150","DOI":"10.1172\/JCI121372","article-title":"TNF\/TNFR axis promotes pyrin inflammasome activation and distinctly modulates pyrin inflammasomopathy","volume":"129","author":"Sharma","year":"2019","journal-title":"J Clin Invest"},{"key":"B4","doi-asserted-by":"publisher","first-page":"20143085","DOI":"10.1098\/rspb.2014.3085","article-title":"Evolution of the immune system in humans from infancy to old age","volume":"282","author":"Simon","year":"2015","journal-title":"Proc Biol Sci"},{"key":"B5","doi-asserted-by":"publisher","first-page":"11","DOI":"10.1186\/s43162-021-00040-5","article-title":"Bridging autoinflammatory and autoimmune diseases","volume":"33","author":"El-Shebiny","year":"2021","journal-title":"Egypt J Intern Med"},{"key":"B6","doi-asserted-by":"publisher","first-page":"156","DOI":"10.1007\/s12016-020-08825-2","article-title":"Inflammasomes and childhood autoimmune diseases: a review of current knowledge","volume":"61","author":"Yang","year":"2021","journal-title":"Clin Rev Allergy Immunol"},{"key":"B7","doi-asserted-by":"publisher","first-page":"112439","DOI":"10.1016\/j.nut.2024.112439","article-title":"Are the nutritional status and growth parameters of children with juvenile idiopathic arthritis akin to their healthy peers? 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