title: Interleukin-1 blockade in refractory giant cell arteritis.
abstract: Giant cell arteritis is a primary large-vessel vasculitis characterized by an arterial wall inflammation associated with intimal hyperplasia leading to arterial occlusion. Glucocorticoids remain the mainstay of giant cell arteritis treatment. However, relapses and glucocorticoid-related complications are frequent and therapeutic options for refractory giant cell arteritis are quite limited. Like tumor necrosis factor-α and interleukin-6, interleukin-1β is also highly expressed in inflamed arterial walls of patients with giant cell arteritis and may contribute in the pathogenesis of this disease. We report treatment of three cases of refractory giant cell arteritis successfully treated with anakinra, an interleukin-1 blockade therapy. Anakinra was effective for all patients, yielding improvement in their inflammation biomarkers and/or in their symptoms, as well as a disappearance of arterial inflammation in PET/CT for two of them.
authors.affiliation: Service de médecine interne A, CHU de Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France. Electronic address: kim.ly@chu-limoges.fr.
authors.forename: Kim-Heang
authors.initials: KH
authors.lastname: Ly
authors.affiliation: Service de médecine interne, hôpital Jean-Verdier, Assistance Publique-hôpitaux de Paris, Bondy, France.
authors.forename: Jérôme
authors.initials: J
authors.lastname: Stirnemann
authors.affiliation: Service de médecine interne A, CHU de Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
authors.forename: Eric
authors.initials: E
authors.lastname: Liozon
authors.affiliation: Service de médecine interne, hôpital Henri-Mondor, Assistance Publique-hôpitaux de Paris, Créteil, France.
authors.forename: Marc
authors.initials: M
authors.lastname: Michel
authors.affiliation: Service de médecine interne, hôpital Jean-Verdier, Assistance Publique-hôpitaux de Paris, Bondy, France.
authors.forename: Olivier
authors.initials: O
authors.lastname: Fain
authors.affiliation: Service de médecine interne A, CHU de Dupuytren, 2, avenue Martin-Luther-King, 87042 Limoges cedex, France.
authors.forename: Anne-Laure
authors.initials: AL
authors.lastname: Fauchais
mesh_terms: D000368:Aged; D000369:Aged, 80 and over; D018501:Antirheumatic Agents / Q000627:therapeutic use*; D005260:Female; D013700:Giant Cell Arteritis / Q000000981:diagnostic imaging / Q000188:drug therapy*; D005938:Glucocorticoids / Q000627:therapeutic use; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D007375:Interleukin-1 / Q000037:antagonists & inhibitors*; D008297:Male; D049268:Positron-Emission Tomography
chemical_list: D018501:Antirheumatic Agents; D005938:Glucocorticoids; D053590:Interleukin 1 Receptor Antagonist Protein; D007375:Interleukin-1
keywords: Case report; Giant cell arteritis; Interleukin-1 blockade