Identifying Patient Candidates for IL-1 Inhibition: Lessons From Real-World Cases

Avram, Annalina; Duarte, Cátia; Santos, María José; Papagoras, Charalampos; Ritis, Konstantinos; Scarpioni, Roberto; Schmidt, Wolfgang A.; Skendros, Panagiotis

doi:10.1016/s1297-319x(15)30004-x

Cited by 6 publications

(2 citation statements)

References 46 publications

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“…Gout was polyarticular in 46.4% of the patients and tophaceous in 53.8%. Some of the patients presented atypical forms of the disease such as spinal gout ( 25 , 30 ), autoinflammatory syndromes ( 27 ), and sternoclavicular joint arthritis ( 34 ). Most of the patients had more than one associated comorbidity among the following: hypertension (70.7%), CKD ≥3 (52.85%), DM (35.4%; Table 2 ).…”

Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of anakinra in gouty arthritis: A case series and review of the literature

et al. 2023

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BackgroundGout is the most common type of inflammatory arthritis. Nonsteroidal anti-inflammatory drugs, corticosteroids, and colchicine are the first-line agents, although they are contraindicated in many patients. Blockade of IL-1 with anakinra can be an alternative.ObjectiveTo present a case series of 10 difficult-to-treat gout patients treated with anakinra and perform a scoping review of the effectiveness and safety of anakinra in gout patients.MethodsA total of 1,519 citations were screened. The reviewers ran a two-stage screening process by title/abstract and full-text reading. Thirty-eight articles finally met the selection criteria and were included for data extraction and synthesis. Experience in difficult-to treat and complex clinical scenarios, such as active infection, hemodialysis, and transplantation, were specifically described.ResultsThe study sample comprised 551 patients, from whom 648 flares were finally analyzed. The mean age was 57.9 years, and 82.9% were men. The clinical presentation was polyarticular in 47.5% and tophaceous in 66.9%. Sixty-five patients with an active infection, 41 transplanted patients and 14 in haemodyalisis treated with anakinra are described. More than half of the patients had >1 associated comorbidity. Anakinra was effective both for flares (94%) and for long-term treatment (91%) and well tolerated. In the case of flares, 34 (6.7%) adverse effects were registered. Adverse events were more prevalent in long-term treatment.ConclusionAnakinra was effective and safe for management of gout flares in difficult-to-treat patients. It has been used in multiple complex scenarios, such as active infections, dialysis, transplantation, chronic kidney disease, and polyarticular gout. Anakinra has also proven effective as long-term treatment, although there are more concerns about its safety.

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Section: Resultsmentioning

confidence: 99%

Effectiveness and safety of anakinra in gouty arthritis: A case series and review of the literature

et al. 2023

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“…10 Resistant tophaceous gout also responds to on demand administration of anakinra, in combination with sub-optimal doses of allopurinol, with faster steroids tapering. 11,12 There were excellent results in patients burdened by multiple comorbidities, whose gout attacks benefited from anakinra continuous treatment, 13 and in complex hospitalized patients, thanks to the drug's short half-life, rapidity of action and good tolerability. 14,15 Clinical improvements also occurred in patients with chronic kidney failure at the 4-5 stage and in patients with kidney transplantation.…”

Section: Goutmentioning

confidence: 99%

Off-label use of anti-IL-1 drugs in rheumatic diseases

Stefania

Colìa

Rotondo

et al. 2021

Int J Immunopathol Pharmacol

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Interleukin-1 (IL-1) plays a key role in the pathogenesis of different rheumatic diseases. There are now several agents available on the market capable of blocking IL-1. The proven effectiveness and excellent safety of these drugs makes them a possible therapeutic option in the treatment of IL-1 driven diseases, when previous therapies are contraindicated or ineffective. This article discusses the European wide off-label use of these drugs for the treatment of rheumatic diseases.

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Seltene Manifestationen der Arthritis urica am Achsenskelett

et al. 2016

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Clinical manifestations of gouty arthropathy are usually acute inflammatory arthritis, bursitis and accumulation of urate crystals in the form of tophi. Manifestations on the axial skeleton are also known and have been described but occur infrequently and for this reason play a subordinate role in the awareness of rheumatologists. With dual energy computed tomography (CT) gout tophi can be detected even in unusual regions or regions that are difficult to access for puncturing. We describe two rare cases of gouty arthropathy of the axial skeleton in a 76-year-old male patient with spinal involvement and in a 53-year-old female patient with involvement of the sacroiliac joint. In both cases the diagnosis was achieved with dual energy CT.

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Identifying Patient Candidates for IL-1 Inhibition: Lessons From Real-World Cases

Cited by 6 publications

References 46 publications

Effectiveness and safety of anakinra in gouty arthritis: A case series and review of the literature

Effectiveness and safety of anakinra in gouty arthritis: A case series and review of the literature

Off-label use of anti-IL-1 drugs in rheumatic diseases

Seltene Manifestationen der Arthritis urica am Achsenskelett

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