Author: Erdal Sag
There were two major topics for paediatric RMD at EULAR 2023 congress. The first one is new treatment options and the other one is the new biomarkers for different disease subsets.
Zimmer et al. (OP0163) evaluated the efficacy and safety of golimumab in the treatment of polyarticular JIA patients from BiKER registry. They included 141 patients treated with Golimumab compared with 282 patients receiving alternative anti-TNF treatment and 135 biologic-naïve patients receiving methotrexate. They reported an acceptable safety profile of GOL therapy, comparable to treatment with aTNFi or MTX with a favorable effectiveness. AE and serious infection rates between the three cohorts were comparable.
Brunner et al. (OP0164) reported the interim results of phase 1 trial of Upadacitinib in the treatment of Polyarticular JIA. They included 57 patients and showed that a high proportion of patients across all age groups achieved JIA ACR30, 50, and 70 response at week 12 with an improvement from baseline to week 12 in C-HAQ and JADAS-27 [CRP] scores.
De Benedetti et al. (OP0166) evaluated the long term results of emapalumab in 14 patients with sJIA or AOSD who were resistant to high dose GCs. 13/14 pts with MAS who had failed high-dose GCs and responded to emapalumab remained in remission and continued GC tapering during 12 months of follow-up. Any viral infections during follow-up resolved spontaneously or with standard treatment, confirming the favorable safety profile of emapalumab.
Foell et al. (OP0034) proposed a new immuno-turbidometric assay (sCAL turbo) on an automated laboratory instrument for measurement of S100A8/A) which showed an excellent correlation with ELISA. It could reliably differentiate SJIA from all other diagnoses with significant accuracy (cut-off at 9,100ng/ml, sensitivity 93%, specificity 87%, ROC area under curve 0.961, p<0.001).
De Matteis et al. (POS0133) tried to define new biomarkers to differentiate MAS from secondary HLH. They included 41 with sHLH, 41 with MAS in the context of sJIA, and 24 with sJIA without MAS. Their results confirmed that platelet count, ferritin and LDH could help to discriminate MAS in sJIA; IL-18 and the IFN-γ related biomarkers (CXCL9 and CXCL10) were significantly higher in patients with MAS and sHLH and might be useful to diagnose MAS/sHLH. IL-18 could help to distinguish sHLH from MAS and MAS from active sJIA.
Bergkamp et al. (POS0134) reported that at different time points, serum levels of Angiopoietin-2, VCAM-1 and TWEAK were increased in cSLE patients, irrespective of disease activity. The endothelium in cSLEseemed to stay in an active state, even in low disease activity (SLEDAI≤4). They speculated that some EC markers might be useful as biomarkers for predicting the ongoing risk for endothelial dysfunction in cSLE.
ABOUT THE AUTHOR
Erdal Sag
Erdal is the Head of the Department of Pediatric Rheumatology, Ankara Training and Research Hospital, Ankara, Turkey.
He has finished his MSc on Pediatric Autoinflammatory Diseases. His major research interests include T cell exhaustion in JIA, childhood vasculitis and autoinflammatory diseases.
He is the Chair of PRES/EMERGE group and a member of EULAR PAED Committee.