This is an observational pre-post study to observe if the off label use of anti-IL1 therapies, such as anakinra or canakinumab, can block ACVR1-induced flare activity and heterotopic ossification in FOP. It will also generate key tools and preliminary data that are needed to design a future Phase II study. This study specifically focuses on patients with severe FOP who are being considered by their medical team for rescue therapy with anti-IL1 therapy. Preliminary data suggests patients experience significant decreases in flare frequency when taking anti-IL1 therapy, but other measures of efficacy remain unassessed, such as changes in heterotopic ossification formation, changes in pain medication use, and changes in functionality.
The investigators will perform an observational study on patients with FOP who have decided, along with their primary medical team, to start anti-IL1 therapy with either anakinra or canakinumab due to intractable or unusually severe FOP disease progression. The investigators will study 11 subjects aged 6-30 years old, with a self-reported flare frequency of at least 4 flares/year \[2 times above the average reported FOP population flare frequency of 2 flares/year\] or with an intractable flare that has lasted greater than 1 month. Subjects will begin an observational period during the medication prescription and insurance approval process and will then be followed for up to 1 year after treatment has been initiated by the medical management team. Low-dose whole-body CT (WBCT) imaging, bloodwork, patient-reported outcomes, pain, and flare activity will be assessed during this study. In addition, patients who are currently on anti-IL1 therapy will be enrolled in a separate observation-only arm to collect historical data related to their experiences on therapy.
Study Type
OBSERVATIONAL
Enrollment
11
Anti-IL1 is a rescue therapy for FOP patients that is hypothesized to reduce flare activity and subsequent ossification in these patients
UCSF
San Francisco, California, United States
RECRUITINGNumber of flares that a patient experiences.
Surveys will be used to track the number of clinical flares that a patient experiences before and during treatment with anti-IL1 therapy.
Time frame: 1 year
Change in new heterotopic ossification bone formation over time
Low dose whole body CT (WBCT) without the head, will be used to create detailed images of the skeletal system. The images will be used to measure new HO bone formation from baseline.
Time frame: 1 year
Changes in blood inflammatory cytokine levels with anti-IL1 therapy
Blood samples will be taken to measure changes in the inflammatory cytokines present in the blood over time, and if this changes with anti-IL1 treatment.
Time frame: 1 year
Change in patient mobility
The Cumulative Analog Joint Involvement Scale (CAJIS) will be used to assess 15 major joints for their mobility. This will be compared from baseline vs. 1 year of anti-IL1 treatment.
Time frame: 1 year
Number of participants with treatment emergent adverse events (TEAEs)
The number of participants with adverse events (ie adverse events not at baseline) will be collected during the treatment period.
Time frame: 1 year
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