2009
DOI: 10.1111/j.1365-2133.2009.09404.x
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Targeted treatment of pyoderma gangrenosum in PAPA (pyogenic arthritis, pyoderma gangrenosum and acne) syndrome with the recombinant human interleukin-1 receptor antagonist anakinra

Abstract: The triad of sterile pyogenic arthritis, pyoderma gangrenosum and acne is known by the acronym of PAPA syndrome. It is a rare autosomal dominant disease of early onset. The treatment of pyoderma gangrenosum is challenging as there is often only partial response to systemic glucocorticosteroids and immunosuppressive therapies. We report the rapid and lasting response of pyoderma gangrenosum to the targeted treatment with the recombinant human interleukin-1 receptor antagonist (rHuIL-1Ra) anakinra in a patient w… Show more

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Cited by 208 publications
(121 citation statements)
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References 27 publications
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“…Monocytes from PAPAS patients produce significantly higher amount of IL-1␤ compared with those from normal subjects in response to LPS stimulation (8). Furthermore, PAPAS patients respond to anti-IL-1 therapy (9,10). Taken together, these observations suggest that excessive production of IL-1 likely underlie the pathology of PAPAS.…”
supporting
confidence: 56%
“…Monocytes from PAPAS patients produce significantly higher amount of IL-1␤ compared with those from normal subjects in response to LPS stimulation (8). Furthermore, PAPAS patients respond to anti-IL-1 therapy (9,10). Taken together, these observations suggest that excessive production of IL-1 likely underlie the pathology of PAPAS.…”
supporting
confidence: 56%
“…Anakinra has been used to prevent attacks and reduce systemic inflammatory markers in patients with colchicine-resistant FMF, [20][21][22][23][24][25] hyper-IgD syndrome, [26][27][28] and even etanercept-resistant TRAPS. 14,29,30 Similar remarkable responses were also reported in patients with Blau syndrome, 31,32 pyogenic arthritis, pyoderma gangrenosum, and acne 6,33,34 and deficiency of IL-1 receptor antagonist. 5,6 Anakinra has also been shown to be effective during acute gout episodes, 35,36 chronic gout, 35 and pseudogout 37,38 and in the management of Schnitzler syndrome, [39][40][41][42][43][44][45] systemic-onset juvenile idiopathic arthritis, [46][47][48] and adult-onset Still disease.…”
Section: Il-1-targeted Therapy In Other Autoinflammatory Diseasessupporting
confidence: 57%
“…It was discovered that the PAPA-inducing mutation in PSTPIP1 results in aberrant inflammasome activation and IL-1β-driven pathology in patients, suggesting that PSTPIP1 is a novel negative regulator of inflammasomes (23)(24)(25)(26). In line with this, IL-1 blockade therapies including Anakinra treatment have proven effective in controlling inflammatory flares in PAPA syndrome patients (27,28). Both PSTPIP1 and PSTPIP2 share an N-terminal Fer-CIP4 homology (FCH) domain and a central coiled coil domain (19).…”
Section: Discussionmentioning
confidence: 78%