title: Partial clinical response to anakinra in severe palmoplantar pustular psoriasis.
abstract: BACKGROUND
  Palmoplantar pustular psoriasis is a clinical psoriasis variant characterised by a high impact on quality of life and poor response to biologics approved for plaque type psoriasis.The recombinant interleukin-1 (IL-1) receptor antagonist anakinra has been recently used for the treatment of isolated refractory cases of generalised pustular psoriasis with contrasted results.
  
  
  OBJECTIVE
  To report the clinical response in two patients treated with anakinra as salvage therapy in two patients with severe palmoplantar pustular psoriasis refractory to currently available antipsoriatic systemic therapies.
  
  
  METHODS
  Anakinra was given subcutaneously at the daily dose of 100 mg, and clinical response was evaluated using the palmoplantar psoriasis area and severity index (PPPASI).
  
  
  RESULTS
  Only partial and transient responses were observed in both patients, who had to stop anakinra due to lack of efficacy and to side effects.
  
  
  CONCLUSIONS
  Anakinra appears to provide only partial clinical improvement in refractory palmoplantar pustular psoriasis. Prospective clinical studies on larger populations are warranted to investigate more accurately both efficacy and safety of IL-1-inhibiting strategies in pustular psoriasis.
authors.affiliation: Université Paris Diderot-Sorbonne, Paris Cité, Department of Dermatology, Hôpital Saint-Louis, APHP, 1 avenue Claude-Vellefaux, 75475 Cedex 10, Paris, France; Laboratory of genetics of autoinflammatory diseases, Université Paris Diderot-Sorbonne, Paris Cité, Institut Imagine, Hôpital Necker-Enfants Malades, Paris, France.
authors.forename: M
authors.initials: M
authors.lastname: Tauber
authors.forename: M
authors.initials: M
authors.lastname: Viguier
authors.forename: E
authors.initials: E
authors.lastname: Alimova
authors.forename: A
authors.initials: A
authors.lastname: Petit
authors.forename: F
authors.initials: F
authors.lastname: Lioté
authors.forename: A
authors.initials: A
authors.lastname: Smahi
authors.forename: H
authors.initials: H
authors.lastname: Bachelez
mesh_terms: D000368:Aged; D003879:Dermatologic Agents / Q000627:therapeutic use*; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000627:therapeutic use*; D008297:Male; D008875:Middle Aged; D011565:Psoriasis / Q000188:drug therapy*; D016896:Treatment Outcome
chemical_list: D003879:Dermatologic Agents; D053590:Interleukin 1 Receptor Antagonist Protein