An open-label study of anakinra for the treatment of moderate to severe hidradenitis suppurativa

Leslie, Kieron; Tripathi, Shivani; Nguyen, Tien V.; Pauli, Mariela; Rosenblum, Michael D.

doi:10.1016/j.jaad.2013.09.044

Cited by 97 publications

(75 citation statements)

References 32 publications

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“…It is also associated with other inflammatory syndromes with skin, bone and joint involvement: Synovitisacne-pustulosis-hyperostosis-osteitis (SAPHO), PASH syndrome (acne conglobata, pyoderma gangrenosum and HS), PASS syndrome (pyoderma gangrenosum, acne conglobata, HS and axial spondyloarthritis) and PAPASH syndrome (pyoderma gangrenosum, acne, psoriasis, arthritis and suppurative hidradenitis) [13,14]. Prevalence of inflammatory arthritis is increased in severe HS, with a predominance of spondyloarthritis (SA) [12,15].…”

Section: Discussionmentioning

confidence: 99%

Association of hidradenitis suppurativa and familial Mediterranean fever: A case series of 6 patients

et al. 2017

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Section: Discussionmentioning

confidence: 99%

Association of hidradenitis suppurativa and familial Mediterranean fever: A case series of 6 patients

et al. 2017

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“…The use and success of Anakinra for the treatment of HS has been a matter of controversy (van der Zee and Prens, 2013; Zarchi et al, 2013; Leslie et al, 2014; Menis et al, 2015; Russo and Alikhan, 2016). However, in a recent double-blind, randomized, placebo controlled trial, 20 patients were treated with Anakinra or placebo daily for 12 weeks.…”

Section: Skin Diseases With Il-1 Involvementmentioning

confidence: 99%

Potential of IL-1, IL-18 and Inflammasome Inhibition for the Treatment of Inflammatory Skin Diseases

2017

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In 2002, intracellular protein complexes known as the inflammasomes were discovered and were shown to have a crucial role in the sensing of intracellular pathogen- and danger-associated molecular patterns (PAMPs and DAMPs). Activation of the inflammasomes results in the processing and subsequent secretion of the pro-inflammatory cytokines IL-1β and IL-18. Several autoinflammatory disorders such as cryopyrin-associated periodic syndromes and Familial Mediterranean Fever have been associated with mutations of genes encoding inflammasome components. Moreover, the importance of IL-1 has been reported for an increasing number of autoinflammatory skin diseases including but not limited to deficiency of IL-1 receptor antagonist, mevalonate kinase deficiency and PAPA syndrome. Recent findings have revealed that excessive IL-1 release induced by harmful stimuli likely contributes to the pathogenesis of common dermatological diseases such as acne vulgaris or seborrheic dermatitis. A key pathogenic feature of these diseases is IL-1β-induced neutrophil recruitment to the skin. IL-1β blockade may therefore represent a promising therapeutic approach. Several case reports and clinical trials have demonstrated the efficacy of IL-1 inhibition in the treatment of these skin disorders. Next to the recombinant IL-1 receptor antagonist (IL-1Ra) Anakinra and the soluble decoy Rilonacept, the anti-IL-1α monoclonal antibody MABp1 and anti-IL-1β Canakinumab but also Gevokizumab, LY2189102 and P2D7KK, offer valid alternatives to target IL-1. Although less thoroughly investigated, an involvement of IL-18 in the development of cutaneous inflammatory disorders is also suspected. The present review describes the role of IL-1 in diseases with skin involvement and gives an overview of the relevant studies discussing the therapeutic potential of modulating the secretion and activity of IL-1 and IL-18 in such diseases.

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“…In HS elevated levels of IL-1 have been demonstrated in lesional and perilesional skin [17]. To date, ten patients have been treated with anakinra with mixed results [88][89][90][91][92]. In seven patients anakinra showed clear improvement of the HS lesions [88,89,92], whereas in the other three patients with severe HS, anakinra was ineffective [90,91].…”

Section: Anakinramentioning

confidence: 99%

An Update on Medical Treatment Options for Hidradenitis Suppurativa

Deckers

Prens

2015

Drugs

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Hidradenitis suppurativa (HS) is a chronic inflammatory skin disease characterized by recurrent inflammatory nodules mostly located in the armpits and groin. Over the years multiple treatments for HS have been proposed; however, to date a cure is still lacking. In this update we provide an overview of most drug treatments reported on for HS, where possible with their mode of action and side effects. In mild cases, clindamycin lotion or resorcinol cream have proven effective. Tetracyclines are a first-line systemic option in more widespread or severe cases, followed by the combination of clindamycin and rifampicin. However, the recurrence rate is high after discontinuation of clindamycin plus rifampicin combination therapy. Long-term treatment with retinoids, especially acitretin is feasible, although teratogenicity has to be taken into account in females of reproductive age. Multiple antiinflammatory drugs have been suggested for HS, such as dapsone, fumarates or cyclosporine. However, their effectiveness in HS is based on small case series with varying results. If most common treatments have failed, biologics (e.g., infliximab or adalimumab) are the next step. Although not addressed in this review, surgical interventions are often needed to achieve remission. Key PointsHidradenitis suppurativa (HS) is a chronic inflammatory skin disease without a cure.Antibiotics (topical or oral) are often the first treatment option for HS.In cases of more extensive or therapy-resistant HS, biologicals (e.g., infliximab or adalimumab) are a good therapeutic option.

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An open-label study of anakinra for the treatment of moderate to severe hidradenitis suppurativa

Cited by 97 publications

References 32 publications

Association of hidradenitis suppurativa and familial Mediterranean fever: A case series of 6 patients

Association of hidradenitis suppurativa and familial Mediterranean fever: A case series of 6 patients

Potential of IL-1, IL-18 and Inflammasome Inhibition for the Treatment of Inflammatory Skin Diseases

An Update on Medical Treatment Options for Hidradenitis Suppurativa

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