Interleukin 1β Blockade Improves Signs and Symptoms of Chronic Calcium Pyrophosphate Crystal Arthritis Resistant to Treatment

Abstract

A 54-year-old woman with recurrent episodes of bilateral knee arthritis was admitted several times to the Department of Rheumatology. She was diagnosed to have chronic calcium pyrophosphate crystal arthritis. Interleukin 1β (IL-1β) plays a central role in the pathogenesis of inflammation induced by calcium pyrophosphate crystals, and IL-1β blockade may be an effective treatment in patients with severe chronic calcium pyrophosphate crystal arthritis. Because of the short effect of treatment with corticosteroids and the frequent attacks of arthritis, the patient was treated with the IL-1 receptor antagonist anakinra. She responded well after 1 week with normalization of inflammation. Eight months after the initiation of treatment, the patient has had no relapses, although we were unable to withdraw the anakinra.

Crystallopathies

“…Inflammasome-mediated release of interleukin-1β was validated as a pathway common to most of the diseases discussed here, through demonstration of protection from inflammation and injury in Nlrp3-deficient mice 32,33,38,44,47,56,62 and of amelioration of inflammation and injury by interleukin-1 antagonist therapy in mice and humans. [33][34][35]40,63 Drugs that can suppress interleukin-1-related inflammation include the interleukin-1β neutralizing antibody canakinumab, the fusion protein of the interleukin-1R and human IgG rilonacept, and the recombinant human interleukin-1R antagonist anakinra. Canakinumab was approved in Europe for the treatment of recurrent gouty arthritis on the basis of its capacity to rapidly suppress inflammatory pain in gouty arthritis and to prevent further gout attacks.…”

Current strategy in the treatment of calcium pyrophosphate crystal deposition disease

“…На сегодняшний день доступны только публикации об эффективности анакинры (ингибитора ИЛ1β) при острых и хронических артритах у пациентов с БДПК [43][44][45][46][47][48][49]. Данных о применении другого ингибитора ИЛ1β (канакинумаба) нет.…”

Interleukin-1 as a therapeutic target in gout

“…Only retrospective series or case reports of patients (total: 27 patients) treated with anakinra have been published up to now [33][34][35][36][37][38]. Most patients received a short treatment of 3 days and presented a good clinical response.…”