Efficacy of anakinra in gouty arthritis: a retrospective study of 40 cases.

Abstract

INTRODUCTION:

Gout is a common arthritis that occurs particularly in patients who frequently have associated comorbidities that limit the use of conventional therapies. The main mechanism of crystal-induced inflammation is interleukin-1 production by activation of the inflammasome. We aimed to evaluate the efficacy and tolerance of anakinra in gouty patients.

METHODS:

We conducted a multicenter retrospective review of patients receiving anakinra for gouty arthritis. We reviewed the response to treatment, adverse events and relapses.

RESULTS:

We examined data for 40 gouty patients (32 men; mean age 60.0 ± 13.9 years) receiving anakinra. Mean disease duration was 8.7 ± 8.7 years. All patients showed contraindications to and/or failure of at least two conventional therapies. Most (36; 90%) demonstrated good response to anakinra. Median pain on a 100-mm visual analog scale was rapidly decreased (73.5 (70.0 to 80.0) to 25.0 (20.0 to 32.5) mm, P < 0.0001), as was median C-reactive protein (CRP) level (130.5 (55.8 to 238.8) to 16.0 (5.0 to 29.5) mg/l, P < 0.0001). After a median follow-up of 7.0 (2.0 to 13.0) months, relapse occurred in 13 patients after a median delay of 15.0 (10.0 to 70.0) days. Seven infectious events, mainly with long-term use of anakinra, were noted.

CONCLUSIONS:

Anakinra may be efficient in gouty arthritis, is relatively well tolerated with short-term use, and could be a relevant option in managing gouty arthritis when conventional therapies are ineffective or contraindicated. Its long-term use could be limited by infectious complications.

• Authors: Sébastien Ottaviani, Anna Moltó, Hang-Korng Ea, Séverine Neveu, Ghislaine Gill, Lauren Brunier, Elisabeth Palazzo, Olivier Meyer, Pascal Richette, Thomas Bardin, Yannick Allanore, Frédéric Lioté, Maxime Dougados, Philippe Dieudé
• Journal: Arthritis research & therapy (Arthritis Res Ther) Vol. 15 Issue 5 Pg. R123 ( 2013) ISSN: 1478-6362 [Electronic] England
• PMID: 24432362 (Publication Type: Journal Article, Multicenter Study)

Chemical References

• Antirheumatic Agents
• Interleukin 1 Receptor Antagonist Protein
• C-Reactive Protein

Topics

• Aged
• Antirheumatic Agents (adverse effects, therapeutic use)
• Arthritis, Gouty (drug therapy, pathology)
• C-Reactive Protein (metabolism)
• Female
• Follow-Up Studies
• Humans
• Interleukin 1 Receptor Antagonist Protein (adverse effects, therapeutic use)
• Male
• Middle Aged
• Pain Measurement (methods)
• Recurrence
• Retrospective Studies
• Staphylococcal Infections (chemically induced)
• Time Factors
• Treatment Outcome