Anakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure.
We describe the case of a 71-year-old man with recurrent pseudogout attacks affecting multiple joints. He had end-stage renal failure that contra-indicated the use of non-steroidal anti-inflammatory drugs and was resistant to therapy with glucocorticoids. Based on the recent findings that interleukin (IL)-1beta is involved in crystal-induced inflammation, the patient received anakinra, a specific IL-1 inhibitor, in order to treat an acute attack of pseudogout. In addition, anakinra was administered as preventive therapy 3days per week after each hemodialysis session. Under this treatment, he did not present any severe episode of arthritis after a follow-up of 8 months. This observation suggests that anakinra is efficacious and safe for the prevention of crystal-induced arthritis in patients with severe renal failure.
Announ
Nadia
N
Division of Rheumatology, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva School of Medicine, Geneva, Switzerland.
Palmer
Gaby
G
Guerne
Pierre-André
PA
Gabay
Cem
C
D000368:Aged; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D002805:Chondrocalcinosis / Q000150:complications / Q000188:drug therapy* / Q000517:prevention & control*; D000075202:Contraindications; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D007375:Interleukin-1 / Q000037:antagonists & inhibitors; D007676:Kidney Failure, Chronic / Q000150:complications*; D008297:Male; D016896:Treatment Outcome
D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1