A pilot study of IL-1 inhibition by anakinra in acute gout
Open accessAbstract
Monosodium urate crystals stimulate monocytes and macrophages to release IL-1β through the NALP3 component of the inflammasome. The effectiveness of IL-1 inhibition in hereditary autoinflammatory syndromes with mutations in the NALP3 protein suggested that IL-1 inhibition might also be effective in relieving the inflammatory manifestations of acute gout. The effectiveness of IL-1 inhibition was first evaluated in a mouse model of monosodium urate crystal-induced inflammation. IL-1 inhibition prevented peritoneal neutrophil accumulation but TNF blockade had no effect. Based on these findings, we performed a pilot, open-labeled study (trial registration number ISRCTN10862635) in 10 patients with gout who could not tolerate or had failed standard antiinflammatory therapies. All patients received 100 mg anakinra daily for 3 days. All 10 patients with acute gout responded rapidly to anakinra. No adverse effects were observed. IL-1 blockade appears to be an effective therapy for acute gouty arthritis. The clinical findings need to be confirmed in a controlled study.
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Anakinra, an IL-1 receptor antagonist, is used effectively to treat autoinflammatory syndromes and gout in patients.
“Since Anakinra (IL-1ra) is efficiently used in the clinical treatment of autoinflammatory syndromes (26) as well as gout patients (27), the present study suggests a potential use of Anakinra in order to slow down progression of asbestosis, silicosis and possibly other inflammatory lung diseases.”
From Innate Immune Activation Through Nalp3 Inflammasome Sensing of Asbestos and Silica (2008) · cites this paper as [27]
Anakinra was shown to be highly effective in the treatment of patients with gout who could not tolerate or did not respond to previous therapy.
“Anakinra was shown to be highly effective in the treatment of patients with gout who could not tolerate or did not respond to previous therapy108.”
From Sterile inflammation: sensing and reacting to damage (2010) · cites this paper as [108]
In a clinical study of ten patients with gout, all ten patients treated with anakinra had significant relief from symptoms.
“Although the clinical study was small, with only ten patients evaluated, all ten patients treated with anakinra had significant relief from symptoms108.”
From Sterile inflammation: sensing and reacting to damage (2010) · cites this paper as [108]
The clinical study of anakinra in gout was small, with only ten patients evaluated.
“Although the clinical study was small, with only ten patients evaluated, all ten patients treated with anakinra had significant relief from symptoms108.”
From Sterile inflammation: sensing and reacting to damage (2010) · cites this paper as [108]
IL-1 has a crucial role in sterile inflammatory responses.
“Given the crucial role for IL-1 in sterile inflammatory responses, blockade of IL-1R has been tested as a therapeutic target for sterile inflammatory disorders in humans.”
From Sterile inflammation: sensing and reacting to damage (2010) · cites this paper as [108]
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- Authors
- So, A., De Smedt, T., Revaz, S., & Tschopp, J.
- Affiliations
- Centre Hospitalier Universitaire Vaudois (CH)
- University of Lausanne (CH)
- Corresponding author
- So, Alexander
- ORCID
- So, Alexander
- Venue
- Arthritis Research & Therapy
- Published
- 2007-03-12
- Volume
- 9
- Issue
- 2
- Pages
- R28-R28
- ISSN
- 1478-6354 (ISSN-L)
- PMC
- PMC1906806
- OpenAlex
- W2100379211
- Cited by
- 727
- References
- 17
- Citations by year
- 2026: 11 · 2025: 8 · 2024: 12 · 2023: 12 · 2022: 28 · 2021: 21 · 2020: 24 · 2019: 39 · 2018: 29 · 2017: 33 · 2016: 35 · 2015: 40 · 2014: 49 · 2013: 59 · 2012: 70
- FWCI
- 45.72
- Type
- journal article
- Language
- en
- Open access
- gold
- doi.org
- Locations
- Arthritis Research & Therapy (publishedVersion, cc-by)
- PubMed Central (publishedVersion, cc-by)
- PubMed (publishedVersion)
- IRIS (submittedVersion)
- SERVAL (Université de Lausanne) (submittedVersion, other-oa)
- Topics
- Health Sciences › Medicine › Nephrology › Gout, Hyperuricemia, Uric Acid
- Life Sciences › Biochemistry, Genetics and Molecular Biology › Molecular Biology › Inflammasome and immune disorders
- Health Sciences › Medicine › Hematology › Autoimmune and Inflammatory Disorders Research
- Keywords
- anakinra, gout flares, IL-1 inhibition, monosodium urate crystals, NLRP3 inflammasome, IL-1β, neutrophil accumulation, anti-TNF therapy, gout, anti-inflammatory therapy
- MeSH terms
- Adult, Aged, Animals, Chemotaxis, Leukocyte, Female, Humans, Interleukin-1, Male, Middle Aged, Peritonitis, Pilot Projects, Uric Acid, Arthritis, Gouty, Mice, Interleukin 1 Receptor Antagonist Protein
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