Arthropathy, Neurogenic, Nervous System Malformations, Papilledema, Urticaria
Conditions
Keywords
Central Nervous System, Abnormalities, Arthropathy, Urticaria, Papilledema, Auto-Inflammation, Inflammatory Disease, Neonatal Onset Multisystem Inflammatory Disease, NOMID, CINCA Syndrome
Brief summary
This study will evaluate the safety and effectiveness of anakinra (Kineret) for treating patients with neonatal-onset multisystem inflammatory disease (NOMID), also known as chronic infantile neurological, cutaneous and arthropathy (CINCA) syndrome. This disease can cause rash, joint deformities, brain inflammation, eye problems, and learning difficulties. Immune suppressing medicines commonly used to treat other pediatric rheumatologic diseases do not suppress NOMID symptoms and, if used long-term and in high doses, can cause harmful side effects. Anakinra, approved by The Food and Drug Administration for treating rheumatoid arthritis in adults, blocks a substance called IL-1 that may be an important factor in causing the inflammation in NOMID.
Detailed description
This study uses the IL-1 receptor antagonist anakinra to treat children and adults with Neonatal-Onset Multisystem Inflammatory Disease (NOMID), also known as chronic infantile neurological, cutaneous and arthropathy (CINCA) syndrome. NOMID/CINCA syndrome is a rare genetic systemic auto-inflammatory disease that is characterized by a triad of symptoms, including a persistent urticaria-like skin rash, an arthropathy associated with patellar and epiphyseal osseous overgrowth, and neurological manifestations, including chronic aseptic meningitis, optic disc edema, high frequency hearing loss, and mental retardation. Spontaneous genetic mutations in the NACHT domain of CIAS1, a gene located on chromosome 1 have been recently identified in about half of the patients with NOMID/CINCA syndrome. CIAS1 encodes a protein, cryopyrin that is associated with up-regulation of IL-1 production in vitro, which has formed the rationale to target the IL-1 pathway in children with NOMID. During an up to 3- week enrollment period before initiating therapy, we will collect self/parent reported daily diary data and serological samples on up to 3 occasions one week apart, to determine baseline disease activity. These data may be gathered by collaborating centers. At the end of the observation period, patients will be admitted to the NIH for a standardized clinical evaluation and initiation of treatment with anakinra administered at 1 mg/kg/day by regular daily subcutaneous injections. If patients do not fulfill improvement criteria at 1 month, the dose will be escalated between 0.5 and 1 mg/kg/day increments to obtain inflammatory remission. An initial withdrawal study in a subset of 11 patients was performed. The clinical improvement at 3-4 months and the change in serum amyloid A levels (SAA) (a sensitive inflammatory marker) from before treatment to 3-4 months post treatment, and drug safety are the primary clinical outcomes of this study. To assess long-term safety and efficacy, all patients will be observed during an open ended extension phase of the study. Clinical and laboratory parameters will be used to assess safety and efficacy throughout the trial. All patients will be seen every 6 months and annually (as calculated from initiation of anakinra treatment) to further evaluate safety and long term outcomes. During the open ended extension phase of the study, patients who have residual clinical or laboratory evidence of active inflammation may have their dose increased between 0.5 and 1 mg/kg/day increments to a maximum dose of 10 mg/kg/per day to achieve clinical remission. In addition, since no data on the pharmacokinetics (PK) of anakinra in pediatric patients is available with doses exceeding 2 mg/kg/day, we plan to determine the PK of anakinra with each dose escalation.
Interventions
DRUGanakinra
daily injection of subcutaneous injection
Sponsors
National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS)
Study design
Allocation
NA
Intervention model
SINGLE_GROUP
Primary purpose
TREATMENT
Masking
NONE
Eligibility
Sex/Gender
ALL
Healthy volunteers
No
Inclusion criteria
-INCLUSION CRITERIA: 1. There is no age limitation. 2. Patients fulfill at least 2 of the following 3 clinical manifestations: * Typical NOMID rash * CNS involvement (papilledema, CSF pleocytosis, sensorineural hearing loss) * Typical arthropathic changes on radiograph (epiphyseal and/or patellar overgrowth. 3. Onset of manifestations of NOMID/CINCA at less than or equal to 6 months of age. 4. Stable dose of steroids, NSAIDs, DMARDs for 4 weeks prior to enrollment visit. 5. Washout period for biologics: 6 half-lives before anakinra administration for all drugs with anti TNF properties. For etanercept (6 half-lives=24 days) this calculates to drug discontinuation 3 days before enrollment into the observation period, for infliximab and adalimumab (6 half-lives=48 days) drug will be discontinued 27 before the observation period, and for thalidomide (6 half-lives=3 days) drug will be discontinued for 3 days prior to anakinra administration. 6. Patient's or legal guardian's ability and willingness to give informed consent. 7. Females of childbearing potential (young women who have had at least one menstrual period regardless of age) must have a negative urine pregnancy test at baseline prior to performance of any radiologic procedure or administration of study medication. Women of childbearing age and men able to father a child, who are sexually active, will be asked to use a form of effective birth control, including abstinence. 8. Negative PPD test using 5 T.U. intradermal testing per CDC guidelines with exception of inclusion criteria #9 below. 9. Patients with latent TB (positive PPD test) must have adequate therapy for TB initiated prior to first dose of study medication as recommended in published guidelines.
Exclusion criteria
1. Having received live virus vaccine during 3 months prior to baseline visit (1st visit to NIH). 2. Patients with active infections or a history of pulmonary TB infection with or without documented adequate therapy, Patients with current active TB, or recent close exposure to an individual with active TB are excluded from the study. 3. Positive testing for HIV, Hepatitis B or C known or documented at screening, enrollment or baseline visit. 4. Have a history of or concomitant diagnosis of congestive heart failure. 5. History of malignancy. 6. Recent use of IL-1 antagonist within the last three months or prior use of anti CD4 antibody. 7. Known hypersensitivity to E. coli derived products or any components of anakinra. 8. Presence of any other rheumatic disease or major chronic infectious/inflammatory/immunologic disease (e.g. inflammatory bowel disease, psoriatic arthritis, spondyloarthropathy, SLE in addition to NOMID/CINCA). 9. Presence of the following at enrollment visit: ALT or AST greater than 2.0 x upper limit of normal (ULN) of the local laboratories values, creatinine greater than 1.5 xULN, WBC less than 3.6x10(9)/l; platelet count less than 150,000 mm(3). 10. Enrollment in any other investigational clinical study or receiving an investigational agent, or has not yet completed at least 4 weeks since ending another investigational device or drug trial. 11. Subjects for whom there is concern about compliance with the protocol procedures by subject and/or parent/s and legally acceptable representative/s. 12. Lactating females or pregnant females. 13. Patients with asthma will only be included after evaluation by a pulmonary and infectious disease consultation.
Design outcomes
Primary
| Measure | Time frame | Description |
|---|---|---|
| Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches) | Baseline | The severity of the main symptoms of the disease were scored on a scale from 0 (no symptoms) to 4 (highest severity) on a daily basis using a diary. Five key symptoms were included in the primary variable DSSS: fever, headache, rash, joint pain, and vomiting. Each of the diary variables was evaluated as a mean value for a period preceding the visits. The baseline value was the mean value of the 5-30 last days before the first dose of Kineret. For the subsequent visits, the mean value of the last 30 days with data before each visit was used as the response variable. |
| Patient / Parent Global Score of Overall Disease Activity | Baseline | Visual analog assessment of how arthritis affects the patient as rated by the patient themselves or parent. Measured on scale from very well (0 mm) to very poor (100 mm). |
| Parent /Patient Pain Rating | Baseline | Visual analog assessment of how much pain the patient experienced in past week due to illness as rated by the patient themselves or parent. Measured on scale from no pain (0 mm) to very severe pain (100 mm). |
| Childhood Health Assessment Questionnaire (CHAQ) | Baseline | Patient self-assessment (or parent assessment) for how illness affects ability to function in daily life. Includes overall score, overall pain rating, overall global evaluation, subcategories for dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities. Measured on scale of 0-3 from 'Without any difficulty' (0) to 'Unable to do' (3). |
| Serum Amyloid A (SAA) Measurement | Baseline | Serum Amyloid A is an inflammatory marker for NOMID measured using Rapid Automated Enzyme Immunoassay. Normal SAA values were defined as ≤ 10 mg/liter. |
| C-reactive Protein (CRP) Measurement | Baseline | C-reactive protein (CRP) is an inflammatory marker for NOMID. Systemic inflammatory remission was defined as a normal CRP level (≤0.5mg/dl). Analyzed at the NIH Clinical Center Laboratory. |
| Erythrocyte Sedimentation Rate (ESR) Measurement | Baseline | Erythrocyte Sedimentation Rate (ESR) is an inflammatory marker for NOMID. Normal ESR values are defined as ≤ 25 mm/hour. Analyzed at the NIH Clinical Center Laboratory. |
Countries
United States
Participant flow
Participants by arm
| Arm | Count |
|---|---|
| NOMID Patients who met the criteria for NOMID and treated with escalating doses of anakinra 1-5 mg/kg/day to achieve laboratory and organ inflammation remission. | 43 |
| Total | 43 |
Baseline characteristics
| Characteristic | NOMID |
|---|---|
| Age, Categorical <=18 years | 36 Participants |
| Age, Categorical >=65 years | 0 Participants |
| Age, Categorical Between 18 and 65 years | 7 Participants |
| Ethnicity (NIH/OMB) Hispanic or Latino | 8 Participants |
| Ethnicity (NIH/OMB) Not Hispanic or Latino | 33 Participants |
| Ethnicity (NIH/OMB) Unknown or Not Reported | 2 Participants |
| Race (NIH/OMB) American Indian or Alaska Native | 0 Participants |
| Race (NIH/OMB) Asian | 4 Participants |
| Race (NIH/OMB) Black or African American | 1 Participants |
| Race (NIH/OMB) More than one race | 1 Participants |
| Race (NIH/OMB) Native Hawaiian or Other Pacific Islander | 0 Participants |
| Race (NIH/OMB) Unknown or Not Reported | 8 Participants |
| Race (NIH/OMB) White | 29 Participants |
| Sex: Female, Male Female | 25 Participants |
| Sex: Female, Male Male | 18 Participants |
Adverse events
| Event type | EG000 affected / at risk |
|---|---|
| deaths Total, all-cause mortality | — / — |
| other Total, other adverse events | 43 / 43 |
| serious Total, serious adverse events | 18 / 43 |
Outcome results
Primary
Childhood Health Assessment Questionnaire (CHAQ)
Patient self-assessment (or parent assessment) for how illness affects ability to function in daily life. Includes overall score, overall pain rating, overall global evaluation, subcategories for dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities. Measured on scale of 0-3 from 'Without any difficulty' (0) to 'Unable to do' (3).
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Childhood Health Assessment Questionnaire (CHAQ) | 1.1051429 units on a scale | Standard Deviation 0.21122155 |
Primary
Childhood Health Assessment Questionnaire (CHAQ)
Patient self-assessment (or parent assessment) for how illness affects ability to function in daily life. Includes overall score, overall pain rating, overall global evaluation, subcategories for dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities. Measured on scale of 0-3 from 'Without any difficulty' (0) to 'Unable to do' (3).
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Childhood Health Assessment Questionnaire (CHAQ) | 0.590625 units on a scale | Standard Deviation 0.180202 |
Primary
Childhood Health Assessment Questionnaire (CHAQ)
Patient self-assessment (or parent assessment) for how illness affects ability to function in daily life. Includes overall score, overall pain rating, overall global evaluation, subcategories for dressing and grooming, arising, eating, walking, hygiene, reach, grip, and activities.Measured on scale of 0-3 from 'Without any difficulty' (0) to 'Unable to do' (3).
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Childhood Health Assessment Questionnaire (CHAQ) | 0.66346154 units on a scale | Standard Deviation 0.15898857 |
Primary
C-reactive Protein (CRP) Measurement
C-reactive protein (CRP) is an inflammatory marker for NOMID. Systemic inflammatory remission was defined as a normal CRP level (≤0.5mg/dl). Analyzed at the NIH Clinical Center Laboratory.
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | C-reactive Protein (CRP) Measurement | 6.0585 mg/dl | Standard Deviation 2.3462251 |
Primary
C-reactive Protein (CRP) Measurement
C-reactive protein (CRP) is an inflammatory marker for NOMID. Systemic inflammatory remission was defined as a normal CRP level (≤0.5mg/dl). Analyzed at the NIH Clinical Center Laboratory.
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | C-reactive Protein (CRP) Measurement | 8.7511538 mg/dl | Standard Deviation 2.2674947 |
Primary
C-reactive Protein (CRP) Measurement
C-reactive protein (CRP) is an inflammatory marker for NOMID. Systemic inflammatory remission was defined as a normal CRP level (≤0.5mg/dl). Analyzed at the NIH Clinical Center Laboratory.
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | C-reactive Protein (CRP) Measurement | 57.703077 mg/dl | Standard Deviation 7.2213655 |
Primary
Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches)
The severity of the main symptoms of the disease were scored on a scale from 0 (no symptoms) to 4 (highest severity) on a daily basis using a diary. Five key symptoms were included in the primary variable DSSS: fever, headache, rash, joint pain, and vomiting. Each of the diary variables was evaluated as a mean value for a period preceding the visits. The baseline value was the mean value of the 5-30 last days before the first dose of Kineret. For the subsequent visits, the mean value of the last 30 days with data before each visit was used as the response variable.
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches) | 0.10768421 units on a scale | Standard Deviation 0.04158048 |
Primary
Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches)
The severity of the main symptoms of the disease were scored on a scale from 0 (no symptoms) to 4 (highest severity) on a daily basis using a diary. Five key symptoms were included in the primary variable DSSS: fever, headache, rash, joint pain, and vomiting. Each of the diary variables was evaluated as a mean value for a period preceding the visits. The baseline value was the mean value of the 5-30 last days before the first dose of Kineret. For the subsequent visits, the mean value of the last 30 days with data before each visit was used as the response variable.
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches) | 0.75741904 units on a scale | Standard Deviation 0.08370955 |
Primary
Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches)
The severity of the main symptoms of the disease were scored on a scale from 0 (no symptoms) to 4 (highest severity) on a daily basis using a diary. Five key symptoms were included in the primary variable DSSS: fever, headache, rash, joint pain, and vomiting. Each of the diary variables was evaluated as a mean value for a period preceding the visits. The baseline value was the mean value of the 5-30 last days before the first dose of Kineret. For the subsequent visits, the mean value of the last 30 days with data before each visit was used as the response variable.
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Diary Symptom Sum Score (DSSS) (Fever, Rash, Joint Pain, Vomiting, and Headaches) | 0.08704545 units on a scale | Standard Deviation 0.02470396 |
Primary
Erythrocyte Sedimentation Rate (ESR) Measurement
Erythrocyte Sedimentation Rate (ESR) is an inflammatory marker for NOMID. Normal ESR values are defined as ≤ 25 mm/hour. Analyzed at the NIH Clinical Center Laboratory.
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Erythrocyte Sedimentation Rate (ESR) Measurement | 11.35 mm/hour | Standard Deviation 2.4355103 |
Primary
Erythrocyte Sedimentation Rate (ESR) Measurement
Erythrocyte Sedimentation Rate (ESR) is an inflammatory marker for NOMID. Normal ESR values are defined as ≤ 25 mm/hour. Analyzed at the NIH Clinical Center Laboratory.
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Erythrocyte Sedimentation Rate (ESR) Measurement | 56.923077 mm/hour | Standard Deviation 6.3138244 |
Primary
Erythrocyte Sedimentation Rate (ESR) Measurement
Erythrocyte Sedimentation Rate (ESR) is an inflammatory marker for NOMID. Normal ESR values are defined as ≤ 25 mm/hour. Analyzed at the NIH Clinical Center Laboratory.
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Erythrocyte Sedimentation Rate (ESR) Measurement | 11.576923 mm/hour | Standard Deviation 1.3222045 |
Primary
Parent /Patient Pain Rating
Visual analog assessment of how much pain the patient experienced in past week due to illness as rated by the patient themselves or parent. Measured on scale from no pain (0 mm) to very severe pain (100 mm).
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Parent /Patient Pain Rating | 41.22381 units on a scale | Standard Deviation 4.9988185 |
Primary
Parent /Patient Pain Rating
Visual analog assessment of how much pain the patient experienced in past week due to illness as rated by the patient themselves or parent. Measured on scale from no pain (0 mm) to very severe pain (100 mm).
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Parent /Patient Pain Rating | 8.9423077 units on a scale | Standard Deviation 2.892075 |
Primary
Parent /Patient Pain Rating
Visual Analog assessment of how much pain the patient experienced in past week due to illness as rated by the patient themselves or parent. Measured on scale from no pain (0 mm) to very severe pain (100 mm).
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Parent /Patient Pain Rating | 9.8525 units on a scale | Standard Deviation 3.1635745 |
Primary
Patient / Parent Global Score of Overall Disease Activity
Visual analog assessment of how arthritis affects the patient as rated by the patient themselves or parent. Measured on scale from very well (0 mm) to very poor (100 mm).
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Patient / Parent Global Score of Overall Disease Activity | 8.1923077 units on a scale | Standard Deviation 2.7291978 |
Primary
Patient / Parent Global Score of Overall Disease Activity
Visual analog assessment of how arthritis affects the patient as rated by the patient themselves or parent. Measured on scale from very well (0 mm) to very poor (100 mm).
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Patient / Parent Global Score of Overall Disease Activity | 40.22381 units on a scale | Standard Deviation 4.6242215 |
Primary
Patient / Parent Global Score of Overall Disease Activity
Visual analog assessment of how arthritis affects the patient as rated by the patient themselves or parent. Measured on scale from very well (0 mm) to very poor (100 mm).
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Patient / Parent Global Score of Overall Disease Activity | 11.1 units on a scale | Standard Deviation 3.6322025 |
Primary
Serum Amyloid A (SAA) Measurement
Serum Amyloid A is an inflammatory marker for NOMID measured using Rapid Automated Enzyme Immunoassay. Normal SAA values were defined as ≤ 10 mg/liter.
Time frame: 36 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 4.5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Serum Amyloid A (SAA) Measurement | 22.333333 mg/liter | Standard Deviation 7.5122284 |
Primary
Serum Amyloid A (SAA) Measurement
Serum Amyloid A is an inflammatory marker for NOMID measured using Rapid Automated Enzyme Immunoassay. Normal SAA values were defined as ≤ 10 mg/liter.
Time frame: Baseline
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg/day per injection were made as frequently as every 2 weeks to achieve laboratory and organ inflammation remission. Data reported is on 26 patients who completed their 3 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Serum Amyloid A (SAA) Measurement | 220.28077 mg/liter | Standard Deviation 38.27684 |
Primary
Serum Amyloid A (SAA) Measurement
Serum Amyloid A is an inflammatory marker for NOMID measured using Rapid Automated Enzyme Immunoassay. Normal SAA values were defined as ≤ 10 mg/liter.
Time frame: 60 months
Population: Patients started at 1mg/kg by daily subcutaneous injection. Stepwise dose increases of 0.5-1 mg/kg per injection were made as frequently as every 2 weeks up to 5 mg/kg/day to achieve laboratory and organ inflammation remission. Data reported is on 20 patients who completed their 5 year assessment.
| Arm | Measure | Value (MEAN) | Dispersion |
|---|---|---|---|
| NOMID | Serum Amyloid A (SAA) Measurement | 21.3125 mg/liter | Standard Deviation 11.586169 |