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2015 ; 2015
(ä): 792173
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Efficacy of anakinra for various types of crystal-induced arthritis in complex
hospitalized patients: a case series and review of the literature
#MMPMID25922564
Aouba A
; Deshayes S
; Frenzel L
; Decottignies A
; Pressiat C
; Bienvenu B
; Boue F
; Damaj G
; Hermine O
; Georgin-Lavialle S
Mediators Inflamm
2015[]; 2015
(ä): 792173
PMID25922564
show ga
BACKGROUND: There are few data on anakinra use after failure of conventional
medications for crystal-induced peripheral arthritis and/or crowned dens syndrome
among complex hospitalized patients. METHODS: We retrospectively analyzed the
outcome of six patients affected with subacute crystal-induced arthritis who had
received anakinra in second or third line therapy, including three patients with
crowned dens syndrome and three others with gouty arthritis. Patients'
comorbidities, reasons for anakinra use and associated drugs, and outcomes were
recorded. RESULTS: All patients presented with elevated inflammatory syndrome,
systemic symptoms with poly/oligoarthritis. Except for absolute
contraindications, all patients were previously treated with full or decreased
dose of NSAID, colchicine, and/or glucocorticoids, with unsatisfactory response.
All three gouty patients exhibited complete responses in all acute involvements
under anakinra within 3 to 5 days, including one of them who needed the
reintroduction of colchicine treatment that was previously unsuccessful. Crowned
dens syndrome patients, including two with pseudogout and one with subacute
hydroxyapatite deposition disease, needed 9 to 11 days to achieve complete
response. Tolerance to anakinra was good. CONCLUSION: In case series of complex
hospitalized patients, anakinra showed good activity in crowned dens syndrome and
associated crystal-induced peripheral arthritis, with longer treatment duration
than in gouty arthritis.
|Aged
[MESH]
|Anti-Inflammatory Agents, Non-Steroidal/therapeutic use
[MESH]
|Antirheumatic Agents/*therapeutic use
[MESH]
|Arthritis, Gouty/*drug therapy
[MESH]
|Arthritis/*drug therapy
[MESH]
|C-Reactive Protein/metabolism
[MESH]
|Colchicine/therapeutic use
[MESH]
|Comorbidity
[MESH]
|Female
[MESH]
|Glucocorticoids/therapeutic use
[MESH]
|Hospitalization
[MESH]
|Humans
[MESH]
|Inflammation/drug therapy
[MESH]
|Interleukin 1 Receptor Antagonist Protein/*therapeutic use
[MESH]