title: Efficacy of anakinra in calcium pyrophosphate crystal-induced arthritis: a report of 16 cases and review of the literature.
abstract: OBJECTIVE
  Calcium pyrophosphate (CPP) crystal-induced arthritis occurs particularly in elderly people. This population has frequently associated comorbidities and treatments, which could limit the use of conventional therapies (colchicine, non-steroidal anti-inflammatory drugs and corticosteroids). The aim of the study was to evaluate the efficacy and tolerance of anakinra in patients with CPP crystal-induced arthritis.
  
  
  METHODS
  We performed a multicentric retrospective chart review of patients who received anakinra for CPP crystal-induced arthritis. Demographic information, comorbidities, co-prescription, short-term treatment outcomes, adverse event, complication and subsequent flares were reviewed.
  
  
  RESULTS
  A total of 16 patients (12 females, mean age: 80.2±11.1 years) received anakinra (100 mg subcutaneously per day). The mean number of anakinra injection was 15.5±42.9 per patient (median: 3). All patients had contraindication and/or failure to conventional therapies. The majority (14 [87.5%]) of patients with CPP crystal-induced arthritis demonstrated a beneficial response to anakinra therapy: 10 good responses and four partial responses. A relapse occurred in six (37.5%) patients (mean time to relapse: 3.4±4.9 months). One patient had an acute bacterial pneumonitis.
  
  
  CONCLUSIONS
  Our results suggest that anakinra is relatively well tolerated and could be a good option in the treatment of CPP crystal-induced arthritis, illustrating that IL-1β blockade may be helpful to control flares in patients having CPP crystal-induced arthritis for which conventional therapies are ineffective or contra-indicated.
authors.affiliation: Service de rhumatologie, hôpital Bichat, université Paris-Diderot, AP-HP, 46, rue Henri-Huchard, 75018 Paris, France.
authors.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.forename: Lauren
authors.initials: L
authors.lastname: Brunier
authors.forename: Jean
authors.initials: J
authors.lastname: Sibilia
authors.forename: François
authors.initials: F
authors.lastname: Maurier
authors.forename: Marc
authors.initials: M
authors.lastname: Ardizzone
authors.forename: Daniel
authors.initials: D
authors.lastname: Wendling
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Gill
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Palazzo
authors.forename: Olivier
authors.initials: O
authors.lastname: Meyer
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D000305:Adrenal Cortex Hormones / Q000008:administration & dosage; D000368:Aged; D000369:Aged, 80 and over; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage; D018501:Antirheumatic Agents / Q000008:administration & dosage* / Q000009:adverse effects; D002131:Calcium Pyrophosphate / Q000737:chemistry / Q000378:metabolism*; D002805:Chondrocalcinosis / Q000188:drug therapy* / Q000378:metabolism; D003460:Crystallization; D005260:Female; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000008:administration & dosage* / Q000009:adverse effects; D008297:Male; D012189:Retrospective Studies
chemical_list: D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D002131:Calcium Pyrophosphate