Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

Desmarais, Julianna; Chu, Cong Qiu

doi:10.3899/jrheum.180393

Cited by 16 publications

(14 citation statements)

References 10 publications

Supporting

Mentioning

Contrasting

Order By: Relevance

“…The standard anakinra dosing is derived from the pilot study by So, et al, in which individuals with acute gouty arthritis were given anakinra 100 mg subcutaneously daily for 3 doses 8 . Several observational studies, including one from our center, have demonstrated the rapid efficacy of anakinra on pain and swelling in acute gout attacks [9][10][11][12][13][14][15][16][17][18] . The observational data for CPP crystal arthritis have been more limited, but anakinra has also been shown to be effective for acute episodes as well as maintenance therapy 14,19,20,21,22,23,24 .…”

mentioning

confidence: 99%

Use of Anakinra in Hospitalized Patients with Crystal-associated Arthritis

Liew

Gardner²

2019

J Rheumatol

View full text Add to dashboard Cite

Objective.In this retrospective observational study, we assess the efficacy and safety of the interleukin 1 receptor antagonist anakinra in medically complex, hospitalized patients with acute gout and calcium pyrophosphate crystal arthritis.Methods.Adult inpatients treated with anakinra from 2014 to 2017 were identified for inclusion. Charts were reviewed for demographics, comorbidities, laboratory data, pain scores, joint involvement, prior treatment, dosing and response to anakinra, concurrent infections, and surgical interventions. Response to anakinra treatment was determined from review of provider documentation, as well as recorded pain scores on a numeric scale.Results.We identified 100 individuals accounting for 115 episodes of arthritis. This population was 82% male, with an average age of 60 years. Comorbidities included renal disease (45%) and history of organ transplantation (14%). Twenty-nine episodes of arthritis occurred in the perioperative setting. Concurrent infection was present in 34 episodes. Eighty-six episodes of arthritis had partial or complete response to anakinra within 4 days of treatment initiation; 66 episodes had partial or complete response within 1 day of anakinra administration. Anakinra was well tolerated.Conclusion.To our knowledge, this is the largest observational study of anakinra use in the inpatient setting for the acute treatment of crystal-associated arthritis. We observed a rapid response to anakinra, with 75% of episodes significantly improving or completely resolving within 4 days of the first dose. Our data also support the use of this biologic agent in individuals with infections, as well as perioperative individuals and immunosuppressed transplant recipients.

show abstract

mentioning

confidence: 99%

Use of Anakinra in Hospitalized Patients with Crystal-associated Arthritis

Liew

Gardner²

2019

J Rheumatol

View full text Add to dashboard Cite

show abstract

“…Seven of the ten relevant articles found in the search were retrospective studies and were discounted because of possibility of researcher bias due to the methodology of chart review and lack of control groups. [2][3][4][5][6][7][8] One article, Balasubramaniam et al, was a protocol study for a potential randomized controlled trial with no results published at this time. 9 The remaining two articles were clinical trials.…”

Section: Related Literaturementioning

confidence: 99%

IL-1 inhibitor anakinra is an effective alternative to standard treatments for reducing pain due to acute gout flare

Craig

2020

Clin. Res. Pract.

View full text Add to dashboard Cite

show abstract

“…4 Interleukin-1 (IL-1) antagonism, using the IL-1β-specific antibody canakinumab, is approved in Europe for gout flare. Off-label prescription of the soluble IL-1 receptor antagonist anakinra has been reported effective in case series, [5][6][7][8][9][10] including in hospitalized inpatients. [11][12][13][14] Anakinra was noninferior to conventional approved therapies for acute gouty arthritis in a recent controlled trial.…”

Section: Introductionmentioning

confidence: 99%

Patients Prescribed Anakinra for Acute Gout Have Baseline Increased Burden of Hyperuricemia, Tophi, and Comorbidities, and Ultimate All-Cause Mortality

Sharma

Pedersen

Terkeltaub

2019

Clin Med�Insights�Arthritis�Musculoskelet Disord

View full text Add to dashboard Cite

Objective: The interleukin-1 (IL-1) receptor antagonist anakinra is an effective, off-label option in acute gout flares, when conventional therapy options are narrowed. We performed a retrospective, randomized, case-controlled study to gain clinical insight on baseline factors for gout patients most likely to receive anakinra, and ultimate mortality of those who received anakinra. Methods: Of 1451 gout patients seen between January 2003 and January 2015 in a Veterans Affairs (VA) rheumatology group practice, under stringent managed care principles, 13 (100% male), who received anakinra at least once for flares, were compared with 1:4 age- and sex-matched gout controls. Each patient’s first rheumatology encounter was studied by factor analysis for variables associated with later anakinra. Results: At baseline, patients that received anakinra had higher urate burden (palpable tophi [10/13] vs controls [16/52], P = .003), serum urate ([10.6 mg/dL] vs controls [7.6 mg/dL], P < .0001), and East Asian descent ([7/13] vs [16/52], P = .041). The anakinra group had higher ultimate all-cause mortality ([6/13] vs controls [7/52], relative risk [RR] = 3.43, 95% confidence interval [CI] = 1.39-8.48, P = .0076). Factor analysis showed baseline visit palpable tophus and statin use to be most strongly associated with later anakinra use. Increased mortality of anakinra users, as per a factorial analysis, was linked more strongly to comorbidities than to anakinra. Conclusions: At baseline rheumatology gout encounter, higher urate, palpable tophi, statin prescription, and East Asian descent were associated with later anakinra use for flares. Mortality was more closely associated to the presence of comorbidities at baseline rheumatology visit than to anakinra prescription.

show abstract

Utility of Anakinra in Acute Crystalline Diseases: A Retrospective Study Comparing a University Hospital with a Veterans Affairs Medical Center

Cited by 16 publications

References 10 publications

Use of Anakinra in Hospitalized Patients with Crystal-associated Arthritis

Use of Anakinra in Hospitalized Patients with Crystal-associated Arthritis

IL-1 inhibitor anakinra is an effective alternative to standard treatments for reducing pain due to acute gout flare

Patients Prescribed Anakinra for Acute Gout Have Baseline Increased Burden of Hyperuricemia, Tophi, and Comorbidities, and Ultimate All-Cause Mortality

Contact Info

Product

Resources

About