Efficacy of Anakinra for Various Types of Crystal-Induced Arthritis in Complex Hospitalized Patients: A Case Series and Review of the Literature
Efficacy of Anakinra for Various Types of Crystal-Induced Arthritis in Complex Hospitalized Patients: A Case Series and Review of the Literature
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DOI：
10.1155/2015/792173
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发表时间：
2015-01-01
影响因子：
4.6
通讯作者：
Georgin-Lavialle, S.
中科院分区：
文献类型：
--
作者：
Aouba, A.;Deshayes, S.;Georgin-Lavialle, S.
背景在复杂的住院患者中，晶体诱导的外周关节炎和/或冠状齿综合征的常规药物治疗失败后，很少有阿那白滞素的使用数据。方法.我们回顾性分析了6例亚急性晶体诱导性关节炎患者接受阿那白滞素二线或三线治疗的结果，包括3例冠状齿综合征患者和3例痛风性关节炎患者。记录患者的合并症、使用阿那白滞素的原因和相关药物以及结果。结果所有患者均表现为炎症综合征升高、全身症状伴多发性/少发性关节炎。除绝对禁忌症外，所有患者既往均接受过全剂量或减量NSAID、秋水仙碱和/或糖皮质激素治疗，疗效不满意。所有三名痛风患者在阿那白滞素治疗下的所有急性受累均在3至5天内表现出完全反应，其中一名患者需要重新引入秋水仙碱治疗，而之前治疗不成功。冠状齿综合征患者，包括2例假性痛风和1例亚急性羟基磷灰石沉积病，需要9至11天才能达到完全缓解。对阿那白滞素的耐受性良好。结论在复杂的住院患者的病例系列中，阿那白滞素在冠齿综合征和相关的晶体诱导的外周关节炎中表现出良好的活性，治疗持续时间比痛风性关节炎长。
Background. There are few data on anakinra use after failure of conventional medications for crystal-induced peripheral arthritis and/or crowned dens syndrome among complex hospitalized patients. Methods. We retrospectively analyzed the outcome of six patients affected with subacute crystal-induced arthritis who had received anakinra in second or third line therapy, including three patients with crowned dens syndrome and three others with gouty arthritis. Patients' comorbidities, reasons for anakinra use and associated drugs, and outcomes were recorded. Results. All patients presented with elevated inflammatory syndrome, systemic symptoms with poly/oligoarthritis. Except for absolute contraindications, all patients were previously treated with full or decreased dose of NSAID, colchicine, and/or glucocorticoids, with unsatisfactory response. All three gouty patients exhibited complete responses in all acute involvements under anakinra within 3 to 5 days, including one of them who needed the reintroduction of colchicine treatment that was previously unsuccessful. Crowned dens syndrome patients, including two with pseudogout and one with subacute hydroxyapatite deposition disease, needed 9 to 11 days to achieve complete response. Tolerance to anakinra was good. Conclusion. In case series of complex hospitalized patients, anakinra showed good activity in crowned dens syndrome and associated crystal-induced peripheral arthritis, with longer treatment duration than in gouty arthritis.