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Both interleukin 1 and interleukin 6 are implicated in the pathogenesis of juvenile idiopathic arthritis (JIA). In two industry-funded, randomized, placebo-controlled, double-blind trials, researchers examined the efficacy and safety of the interleukin-6 inhibitor tocilizumab and the interleukin-1 inhibitor canakinumab for treatment of systemic JIA. The primary end point was the proportion of patients (age range, 2–19 years) with absence of fever, improvement of >30% in at least three of six core criteria, and no worsening of >30% in more than one criteria.
In the tocilizumab trial, 75 children received intravenous (IV) tocilizumab every 2 weeks for 12 weeks, and 37 children received placebo. At 12 weeks, significantly more patients in the t…