Safety and Efficacy of Anakinra in Severe Hidradenitis Suppurativa

Tzanetakou, Vassiliki; Kanni, Theodora; Giatrakou, Sophia; Katoulis, Alexandros; Papadavid, Evangelia; Netea, Mihai G.; Dinarello, Charles A.; Meer, J.W.M. van der; Rigopoulos, Dimitrios; Giamarellos‐Bourboulis, Evangelos J.

doi:10.1001/jamadermatol.2015.3903

Cited by 219 publications

(200 citation statements)

References 29 publications

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“…However, in a recent double-blind, randomized, placebo controlled trial, 20 patients were treated with Anakinra or placebo daily for 12 weeks. HS clinical response after 12 weeks was 78% in Anakinra-treated patients versus 30% in the placebo group (ClinicalTrials.gov Identifier: NCT01558375) (Tzanetakou et al, 2016). …”

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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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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“…Furthermore, none of the trials reported the percentage of patients that were Hispanic or stratified the responses to adalimumab by race. The majority of the efficacy trials investigating other systemic agents, including etanercept, infliximab, anakinra, and ustekinumab, either did not report race or had largely Caucasian cohorts [37-40]. Taken together, this highlights the underrepresentation of non-Caucasian subjects and the need for trials that enroll more HS patients with SOC and stratify results by racial subgroups (Table 2).…”

Section: Treatment Response In Socmentioning

confidence: 99%

Hidradenitis Suppurativa: Disease Burden and Etiology in Skin of Color

2017

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Hidradenitis suppurativa (HS) is a chronic, debilitating skin disease. Although most studies on HS are conducted in largely Caucasian populations, evidence demonstrates a higher prevalence in patients with skin of color, including African and Hispanic populations. These racial subgroups are likely at risk for greater disease burden due to a higher prevalence of components of the metabolic syndrome, comorbid depression, and low socioeconomic status; however, there is a paucity of research in these populations. Additionally, studies examining the genetic and anatomical basis for HS, as well as the response to HS therapies, are lacking for patients with skin of color. Complicating this issue is the limited access to effective medical care, including dermatologists, for African and Hispanic populations as well as other minority groups. In this review, we identify gaps in the knowledge base, highlight the association between HS and patients with skin of color, and provide direction for much needed research into this condition.

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“…The current medical literature reports the effectiveness and desirability of treating HS with biological agents that inhibit TNF-α especially adalimumab and infliximab [26], but also others such as anakinra (anti-IL-1) [27] and ustekinumab (directed against IL-12 and IL-23) [28] may be a promising treatment strategy. Nevertheless further investigations are needed.…”

Section: Discussionmentioning

confidence: 99%

Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab

et al. 2016

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Hidradenitis suppurativa is a chronic inflammatory disorder characterized by occlusion of the follicular pilosebaceous units of the skin. The treatment options are sometimes very limited and unpleasant odor and abundant drainage complicate the disease. Ankylosing spondylitis is a form of seronegative spondyloarthritis with predominantly axial but also peripheral joint involvement. Both of the conditions lower the patient’s quality of life and affect everyday activities.We describe a 39-year-old male patient with both diseases treated with different medications with only a modest result. After the initiation of a tumor necrosis factor α (TNF-α) inhibitor (adalimumab) the patient experienced first the musculoskeletal and later on the skin improvement. The introduction of TNF-α inhibitors should be considered early in the treatment of overlapping hidradenitis suppurativa and the spondyloarthritis spectrum of conditions. Available medical data confirm the positive results and beneficial effect on disease course, activity and, most importantly, quality of life.

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Safety and Efficacy of Anakinra in Severe Hidradenitis Suppurativa

Cited by 219 publications

References 29 publications

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

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

Hidradenitis Suppurativa: Disease Burden and Etiology in Skin of Color

Improvement of overlapping hidradenitis suppurativa and ankylosing spondylitis after the introduction of adalimumab

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