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Safety profile of anakinra in the management of rheumatologic, metabolic and autoinflammatory disorders


1, 2, 3, 4, 5, 6, 7

 

  1. Interdisciplinary Department of Medicine, University of Bari, Italy.
  2. Institute of Paediatrics, Fondazione Policlinico Universitario A. Gemelli, Università Cattolica del Sacro Cuore, Rome, Italy.
  3. Interdisciplinary Department of Medicine, University of Bari, Italy.
  4. Research Centre of Systemic Autoimmune and Autoinflammatory Diseases, University of Siena, Italy.
  5. Interdisciplinary Department of Medicine, University of Bari, Italy.
  6. Interdisciplinary Department of Medicine, University of Bari, Italy.
  7. Research Centre of Systemic Autoimmune and Autoinflammatory Diseases, University of Siena, Italy. cantariniluca@hotmail.com

CER8893
2016 Vol.34, N°3
PI 0531, PF 0538
Review

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PMID: 26940286 [PubMed]

Received: 24/08/2015
Accepted : 23/11/2015
In Press: 26/02/2016
Published: 30/05/2016

Abstract

Anakinra is a biologic response modifier that competitively antagonises the biologic effects of interleukin-1, the ancestor pleiotropic proinflammatory cytokine produced by numerous cell types, found in excess in the serum, synovial fluid and any involved tissues of patients with many inflammatory diseases. The magnitude of the risk of different infections, including Mycobacterium tuberculosis (Mtb) infection, associated with the large use of anakinra in many rheumatologic, metabolic or autoinflammatory disorders is still unknown. In addition, it is unclear whether this effect is modified by the concomitant use of antirheumatic drugs and corticosteroids. The rates of development of Mtb disease in patients treated with anakinra due to rheumatoid arthritis, systemic autoinflammatory diseases, Schnitzler’s syndrome, Behçet’s disease, adult-onset Still disease, systemic juvenile idiopathic arthritis, gout and diabetes mellitus have been usually very low. However, clinicians must carefully weigh the benefits of biological drugs against their risks, particularly in patients prone to infections. Additional data are needed to understand whether this risk of Mtb infection and reactivation are representative of a class effect related to biologics or whether anakinra bears specifically an intrinsic lower risk in comparison with other biologic drugs.

Rheumatology Article