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Update on the management of systemic juvenile idiopathic arthritis and role of IL-1 and IL-6 inhibition

Authors Grevich S, Shenoi S

Received 5 April 2017

Accepted for publication 2 September 2017

Published 9 November 2017 Volume 2017:8 Pages 125—135

DOI https://doi.org/10.2147/AHMT.S109495

Checked for plagiarism Yes

Review by Single-blind

Peer reviewers approved by Dr Akshita Wason

Peer reviewer comments 2

Editor who approved publication: Professor Alastair Sutcliffe

Sriharsha Grevich, Susan Shenoi

Department of Rheumatology, Seattle Children’s Hospital, Seattle, WA, USA

Abstract: Systemic juvenile idiopathic arthritis (SJIA) is a disease marked with arthritis and several features of systemic inflammation including fevers, rashes, hepatosplenomegaly, lymphadenopathy, and serositis. The presentation can be variable and arthritis can be a later feature. Macrophage activation syndrome can be a life-threatening complication of this illness and requires early recognition and prompt therapy. Advancements in understanding the biology of SJIA have led to the development of cytokine-targeted therapies, mainly interleukin-1 (IL-1) and IL-6 inhibitors that have significantly improved outcomes. In this review, we provide an update on the advances in the understanding of SJIA biology and also the therapeutic options.

Keywords: systemic juvenile idiopathic arthritis, IL-1 inhibitors, IL-6 inhibitors, anakinra, tocilizumab, canakinumab, macrophage activation syndrome

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