title: Efficacy of anakinra in gouty arthritis: a retrospective study of 40 cases.
abstract: BACKGROUND
  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.forename: Sébastien
authors.initials: S
authors.lastname: Ottaviani
authors.forename: Anna
authors.initials: A
authors.lastname: Moltó
authors.forename: Hang-Korng
authors.initials: HK
authors.lastname: Ea
authors.forename: Séverine
authors.initials: S
authors.lastname: Neveu
authors.forename: Ghislaine
authors.initials: G
authors.lastname: Gill
authors.forename: Lauren
authors.initials: L
authors.lastname: Brunier
authors.forename: Elisabeth
authors.initials: E
authors.lastname: Palazzo
authors.forename: Olivier
authors.initials: O
authors.lastname: Meyer
authors.forename: Pascal
authors.initials: P
authors.lastname: Richette
authors.forename: Thomas
authors.initials: T
authors.lastname: Bardin
authors.forename: Yannick
authors.initials: Y
authors.lastname: Allanore
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lioté
authors.forename: Maxime
authors.initials: M
authors.lastname: Dougados
authors.forename: Philippe
authors.initials: P
authors.lastname: Dieudé
mesh_terms: D000368:Aged; D018501:Antirheumatic Agents / Q000009:adverse effects / Q000627:therapeutic use; D015210:Arthritis, Gouty / Q000188:drug therapy* / Q000473:pathology; D002097:C-Reactive Protein / Q000378:metabolism; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000009:adverse effects / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D010147:Pain Measurement / Q000379:methods; D012008:Recurrence; D012189:Retrospective Studies; D013203:Staphylococcal Infections / Q000139:chemically induced; D013997:Time Factors; D016896:Treatment Outcome
chemical_list: D018501:Antirheumatic Agents; D053590:Interleukin 1 Receptor Antagonist Protein; D002097:C-Reactive Protein