SOJIA
SOJIA stands for systemic-onset Juvenile Idiopathic Arthritis (JIV). It is a very severe form of JIA which causes joint pain, inflammation, recurrent fevers, and a skin rash. Patients often take predinsolone, a corticosteroid to manage their symptoms. They may also receive physical therapy, acupuncture, or massages to ease their pain.
Researchers at the Children’s Hospital of Fudan University in China have recently announced positive results from a trail examining a potentially new treatment option for SOJIA called tacrolimus.
Tacrolimus
Tacrolimus is frequently given to individuals who have undergone transplants, to decrease their chance of rejection. It’s an immunosuppressive therapy that blocks IL-2 from being activated. It also blocks production of TNF-α, IL-1β, and IL-6 which are all pro-inflammatory molecules. Tacrolimus is also approved as a treatment for various autoimmune conditions including Rheumatoid arthritis, Lupus nephritis, and refractory nephrotic syndrome.
Other studies have investigated tacrolimus in SOJIA, but not enough to warrant its approval for the condition. This recent study in China has indicated that this treatment certainly warrants further experimentation.
The Study
This study was conducted at one trial site and only included six participants. There were three boys and three girls, all under the age of 18.
Data collected in this study included:
- Duration of disease
- Dose of tacrolimus
- The rate of red blood clot formation
- Levels of C-reactive protein
- Levels of hemoglobin
- Levels of platelets
- Levels of white blood cells
- Dose of predinsolone
- IL-6 expression
Patients were evaluated before treatment, six months after treatment, and one year after treatment.
Results
The below results are from the one year post-treatment follow-up.
- Significant decreases in the rate of red blood clot formation
- Significant decreases in the levels of C-reactive protein
- Significant decreases in the levels of platelets
- Significant decreases in the levels of white blood cells
- Decreases in IL-6 expression resulting in reduced inflammation of tissue
- Significant decreases in doses of predinsolone
- No serious side effects reported from tacrolimus
An increase in the levels of hemoglobin for participants was actually documented after the six month mark. But these levels were lower at the one year mark.
The dose of tacrolimus in this study ranged from 1 to 3 mg per day.
You can read the full study, published in Experimental and Therapeutic Medicine here.
Moving Forward
The researchers who conducted this study fully admit the need for further investigations. These should be conducted at multiple trial sites with a larger group of patients. A deeper examination of the mechanism which tacrolimus uses to aid SOJIA is also needed.
This study, while undoubtedly small, does provide valuable insight to the medical community. Above all else, it indicates that we need to get a move on in our research of tacrolimus in SOJIA. Hopefully, this study will encourage scientists to invest in this research as it has shown they are likely to receive a positive result.
You can read more about this study and tacrolimus as a potential treatment for systemic-onset juvenile idiopathic arthritis here.
