FRI0553 CANAKINUMAB AS A FIRST-LINE AND SECOND-LINE BIOLOGIC FOR TREATMENT OF SYSTEMIC JUVENILE IDIOPATHIC ARTHRITIS IN CHILDREN UNDER 4 YEARS OF AGE

Background Development of biologics and their launching into clinical practice has yielded significant progress in pediatric rheumatology. Nevertheless, treatment of severe disorders, and systemic JIA in particular, still remains a challenge. JIA often has the early-onset form. If its course is aggressive and persistent, patients exhibit poor response to treatment with first-line biologics. Effectiveness of the second-line and subsequent biologics, as well as the optimal sequence of prescribing drugs belonging to different classes to children younger than 4 years, remains an open question Objectives To compare the efficacy of canakinumab (CAN) in children with sJIA younger than 4 years (in biologic-naive patients and when prescribed as a second-line biologic). Methods The study was conducted as a subanalysis of the prospective cohort study to evaluate the efficacy of biologics in children with sJIA. Comparative analysis involved 17 patients who had initiated CAN treatment at the National Medical Research Center of Children’s Health (Moscow, Russia) when aged Results At baseline, patients had comparable duration and severity of the disease. The biologic proved efficacious already after 4 weeks of treatment. Five (55.6%) patients in the naive group and 4 (50%) patients in the switched group achieved ACR90 (p>0.999) within one year of treatment. A state of inactive disease according to the Wallace criteria was achieved in one patient in each group, (12.5% and 11.1%, respectively (p>0.999). JADAS-71 decreased significantly from 12.8 (IQR 10.4-16.2) to 4.4 (IQR 2-6.8) in the naive group (p=0.012) and from 11.6 (IQR 8-13.88) to 2.35 (IQR 1-3.03) in the switched group (p=0.017). Conclusion CAN was found to be highly efficacious and have a good safety profile in children younger than 4 years regardless of prior biologic treatment. Disclosure of Interests None declared