A pilot study of IL-1 inhibition by anakinra in acute gout.

Abstract

Monosodium urate crystals stimulate monocytes and macrophages to release IL-1beta through the NALP3 component of the inflammasome. The effectiveness of IL-1 inhibition in hereditary autoinflammatory syndromes with mutations in the NALP3 protein suggested that IL-1 inhibition might also be effective in relieving the inflammatory manifestations of acute gout. The effectiveness of IL-1 inhibition was first evaluated in a mouse model of monosodium urate crystal-induced inflammation. IL-1 inhibition prevented peritoneal neutrophil accumulation but TNF blockade had no effect. Based on these findings, we performed a pilot, open-labeled study (trial registration number ISRCTN10862635) in 10 patients with gout who could not tolerate or had failed standard antiinflammatory therapies. All patients received 100 mg anakinra daily for 3 days. All 10 patients with acute gout responded rapidly to anakinra. No adverse effects were observed. IL-1 blockade appears to be an effective therapy for acute gouty arthritis. The clinical findings need to be confirmed in a controlled study.

• Authors: Alexander So, Thibaut De Smedt, Sylvie Revaz, Jürg Tschopp
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 9 Issue 2 Pg. R28 ( 2007) ISSN: 1478-6362 [Electronic] England
• PMID: 17352828 (Publication Type: Case Reports, Clinical Trial, Journal Article)

Chemical References

• Interleukin 1 Receptor Antagonist Protein
• Interleukin-1
• Uric Acid

Topics

• Adult
• Aged
• Animals
• Arthritis, Gouty (drug therapy)
• Chemotaxis, Leukocyte (drug effects)
• Female
• Humans
• Interleukin 1 Receptor Antagonist Protein (therapeutic use)
• Interleukin-1 (metabolism)
• Male
• Mice
• Middle Aged
• Peritonitis (chemically induced, drug therapy)
• Pilot Projects
• Uric Acid (toxicity)