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Joint Bone Spine
Volume 76, n° 4
pages 424-426 (juillet 2009)
Doi : 10.1016/j.jbspin.2009.01.001
accepted : 7 January 2009
Anakinra is a possible alternative in the treatment and prevention of acute attacks of pseudogout in end-stage renal failure
 

Nadia Announ, Gaby Palmer, Pierre-André Guerne, Cem Gabay
Division of Rheumatology, Department of Internal Medicine, University Hospitals of Geneva and University of Geneva School of Medicine, Geneva, Switzerland 

Corresponding author. Division of Rheumatology, University Hospitals of Geneva, Av. Beau-Séjour 26, CH 1211 Geneva 14, Switzerland. Tel.: +41 22 382 3500; fax +41 22 382 3509.
Abstract

We describe the case of a 71-year-old man with recurrent pseudogout attacks affecting multiple joints. He had end-stage renal failure that contra-indicated the use of non-steroidal anti-inflammatory drugs and was resistant to therapy with glucocorticoids. Based on the recent findings that interleukin (IL)-1β is involved in crystal-induced inflammation, the patient received anakinra, a specific IL-1 inhibitor, in order to treat an acute attack of pseudogout. In addition, anakinra was administered as preventive therapy 3days per week after each hemodialysis session. Under this treatment, he did not present any severe episode of arthritis after a follow-up of 8months. This observation suggests that anakinra is efficacious and safe for the prevention of crystal-induced arthritis in patients with severe renal failure.

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Keywords : Chondrocalcinosis, IL-1, Pseudogout, End-stage renal failure




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