Anakinra for colchicine-intolerant/colchicine-resistant acute gout flare precipitated by decompensated heart failure

Shaukat, Muhammad Hamza Saad; Shabbir, Muhammad Asim; Singh, Sukhraj; Torosoff, Mikhail; Peredo-Wende, Ruben

doi:10.1007/s11845-020-02322-3

Cited by 2 publications

(4 citation statements)

References 6 publications

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“…Therefore, 38 articles were finally eligible for inclusion in our review. Two of them were RCTs ( 22 , 23 ), while the other 36 studies were observational studies, case reports or case series ( 9 , 11 – 21 , 25 – 48 ). Due to the heterogeneity in study design and population, a scoping review rather than a systematic review was carried out to identify all type of available evidence, key concepts and knowledge gaps.…”

Section: Resultsmentioning

confidence: 99%

“…We specifically describe patients with active infection and patients undergoing haemodialysis or transplantation. However, some patients are treated successfully with anakinra in other refractory or difficult-to-treat conditions, such as grade >3 CKD ( 16 , 19 , 21 , 29 , 35 , 39 ), severe hyperglycaemia ( 47 ), and chronic heart failure or ischaemic heart disease ( 9 , 13 , 16 , 20 , 21 , 36 , 39 ). In all these complex scenarios, anakinra proved to be effective and safe (see Supplementary Table S1 ).…”

Section: Resultsmentioning

confidence: 99%

“…As an alternative, off-label prescription of the IL-1β receptor antagonist anakinra has been reported to be effective and with an acceptable safety profile. Anakinra has been evaluated in refractory cases (9,(11)(12)(13)(14)(15)(16)(17)(18)(19)(20)(21) and in two randomized, double-blind, active-control trials (22,23).…”

Section: Introductionmentioning

confidence: 99%

“…Therefore, IL-1 has been identified as a therapeutic target for gout patients undergoing a flare. In fact, IL-1 antagonism using the IL-1β-specific antibody, canakinumab, has been approved in Europe and in the United States of America for the treatment of flares in patients in whom the standard of care is contraindicated or not well tolerated ( 7 , 8 ), as well as in those who do not respond to NSAIDs and/or colchicine ( 9 ). Nevertheless, its high economic cost may limit its availability in daily clinical practice ( 10 ).…”

Section: Introductionmentioning

confidence: 99%

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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%

Section: Resultsmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

Section: Introductionmentioning

confidence: 99%

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

et al. 2023

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The role of interleukin 1 in the development of human diseases: focus on Anakinra (IL-1 receptor antagonist)

Насонов

Samsonov

2022

Naučno-praktičeskaâ revmatologiâ

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According to modern concepts, human immune-mediated inflammatory diseases (IMIDs), depending on the prevailing mechanisms of immunopathogenesis, are divided into two main categories – autoimmune and autoinflammatory.At the same time, both autoimmune and autoinflammatory mechanisms are involved in the pathogenesis of most IMIDs, the complex interaction of which is reflected in the polymorphism of clinical manifestations, course variants, outcomes, and therapy efficacy. It is assumed that hyperproduction of cytokines of the interleukin (IL) 1 family, which is one of the key regulators of innate immunity, determines the “crossover” between the mechanisms of autoinflammation and autoimmunity in IMIDs. Anakinra is currently used in clinical practice to suppress the pathological effects of IL-1. An analysis of the results of the clinical use of Anakinra indicates that treatment with this drug should be considered as a promising direction in the pharmacotherapy of systemic autoinflammatory diseases (SAIDs) and critical conditions in children and adults associated with the development of hyperinflammation. The main directions of the Anakinra clinical research program are presented, including: determining the place of the drug in the implementation of the "Treat to Target" strategy and personalization of therapy, primarily in patients with “resistant” (difficult-to-treat) subtype of rheumatoid arthritis and comorbid pathology, as well as with severe forms of microcrystalline arthritis; the possibility of using Anakinra to improve the early diagnosis of SAIDs in children and adults; creation of the Russian register of patients with SAIDs, who are potentially indicated for treatment with Anakinra.

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Anakinra for colchicine-intolerant/colchicine-resistant acute gout flare precipitated by decompensated heart failure

Cited by 2 publications

References 6 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

The role of interleukin 1 in the development of human diseases: focus on Anakinra (IL-1 receptor antagonist)

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