Anakinra's Efficacy is Variable in Refractory Gout: Report of Ten Cases

Objectives: To evaluate the efficacy of anakinra for patients with acute gout. Methods: We reviewed the charts of 10 patients who received anakinra for urate crystal-induced arthritis at the Hospital for Special Surgery since 2007. Demographic information, comorbidities, short-term treatment outcomes, and subsequent flares were reviewed. Results: Patients in our study had a high prevalence of comorbidities. All patients received corticosteroids before anakinra treatment. The mean number of anakinra injections was 3.2 per patient (100 mg subcutaneously per day). Six patients had a good response. Three patients had a partial response and 1 patient had no response. Nine patients had documented recurrent flares after discontinuing anakinra (ranging from 3 to 45 days after). Conclusion: Anakinra is a therapeutic option for patients with acute urate crystal-induced arthritis who do not respond to or have a contraindication to traditional treatments. Although a short course of anakinra resulted in favorable outcomes for some of our patients, response rates were poorer in our study than in previously published reports, and relapses were common. (C) 2010 Published by Elsevier Inc. Semin Arthritis Rheum 40:210-214