An Overview of Interleukin-1 Receptor Antagonist, Anakinra, in the Treatment of Cutaneous Diseases

Pazyar, Nader; Feily, Amir; Yaghoobi, Reza

doi:10.2174/157488412803305821

Cited by 44 publications

(26 citation statements)

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“…Treatments serving this purpose may include: colectomy in patients with chronic ulcerative colitis, plasmapheresis or granulocyte apheresis in patients with leukemia, or thalidomide in patients with myelodysplastic syndromes. 43,44 Anti-inflammatory and immunosuppressive drugs can be effective both in PG and the underlying disease, as the example of the IL1 antagonist anakinra for PG in the context of PAPA syndrome, 45,46 and of infliximab and other anti-TNF agents in the context of Crohn's disease and ulcerative colitis. 30,42 Among the anti-TNF biologics, etanercept is the only one reported not to be effective in IBD, which should be taken into consideration when treating these patients.…”

Section: Treatment Of the Underlying Diseasementioning

confidence: 99%

Pyoderma gangrenosum: challenges and solutions

Gameiro¹,

Pereira²,

Cardoso³

et al. 2015

OTT

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Pyoderma gangrenosum (PG) is a rare disease, but commonly related to important morbidity. PG was first assumed to be infectious, but is now considered an inflammatory neutrophilic disease, often associated with autoimmunity, and with chronic inflammatory and neoplastic diseases. Currently, many aspects of the underlying pathophysiology are not well understood, and etiology still remains unknown. PG presents as painful, single or multiple lesions, with several clinical variants, in different locations, with a non specific histology, which makes the diagnosis challenging and often delayed. In the classic ulcerative variant, characterized by ulcers with inflammatory undermined borders, a broad differential diagnosis of malignancy, infection, and vasculitis needs to be considered, making PG a diagnosis of exclusion. Moreover, there are no definitively accepted diagnostic criteria. Treatment is also challenging since, due to its rarity, clinical trials are difficult to perform, and consequently, there is no "gold standard" therapy. Patients frequently require aggressive immunosuppression, often in multidrug regimens that are not standardized. We reviewed the clinical challenges of PG in order to find helpful clues to improve diagnostic accuracy and the treatment options, namely topical care, systemic drugs, and the new emerging therapies that may reduce morbidity.

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Section: Treatment Of the Underlying Diseasementioning

confidence: 99%

Pyoderma gangrenosum: challenges and solutions

Gameiro¹,

Pereira²,

Cardoso³

et al. 2015

OTT

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“…Anakinra is a recombinant human IL-1 receptor antagonist that blocks the inflammatory effects of IL-1 [87]. In HS elevated levels of IL-1 have been demonstrated in lesional and perilesional skin [17].…”

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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“…It's close to Pyoderma gangrenosum, Acne and Pyogenic Arthritis (PAPA) and aseptic abscesses syndromes, where episodes of pyogenic arthritis are described [21]. The PASH syndrome may respond to IL-1␤ blockade [22].…”

Section: Discussionmentioning

confidence: 99%