Modern rheumatology · 2026
Efficacy and safety of anakinra for acute calcium pyrophosphate deposition disease flare: a systematic review and meta-analysis.
СтатьяСистематический обзорМетаанализНазвание и аннотация: Перевод в очереди
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Nakaphan Pannathorn, Phutinart Somkiat, Pajareya Patavee, Jansem Priabprat, Sattawatthamrong Sireenada, Chaisrimaneepan Nattanicha, Jetanalin Pim, Siranart Noppachai
Аннотация
OBJECTIVE: Calcium pyrophosphate deposition disease (CPPD) is a common inflammatory arthritis among older adults. Comorbidities often limit conventional treatment of acute CPPD flare. Anakinra, an interleukin-1 inhibitor, is a promising alternative. We aimed to evaluate the efficacy and safety of anakinra in acute CPPD flares.
METHODS: We systematically searched studies from MEDLINE, EMBASE, and the Cochrane Database up until August 2024. The primary outcome was a positive treatment response between Day 3 and Day 5 after anakinra initiation. Secondary outcomes included changes in pain ratings assessed by the visual analogue scales (VAS), C-reactive protein (CRP) levels, tender joint counts (TJCs), swollen joint counts (SJCs), and steroid usage.
RESULTS: Six studies were included in our meta-analysis: five observational studies and one randomized controlled trial. A total of 84 patients were included in our analysis. Subjective physician assessments of clinical response were reported in all studies with a combined positive treatment response rate of 76% (95% CI: 61-86, I2 = 0%). Our pooled analysis also showed a significant reduction of VAS scores by 48.12 mm (95% CI: 53.21-43.03, I2 = 0%) and CRP levels by 62.09 mg/L (95% CI: 97.74-26.44, I2 = 77%) from baseline. Reductions of TJC and SJC were also demonstrated: 4.86 (95% CI: 5.48-4.23, I2 = 0%) and 3.65 (95% CI: -12.53 to 5.22, I2 = 54%), respectively. Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia.
CONCLUSIONS: Anakinra is a promising alternative treatment for patients with acute CPPD flare as it showed desirable clinical responses and a favourable safety profile.
METHODS: We systematically searched studies from MEDLINE, EMBASE, and the Cochrane Database up until August 2024. The primary outcome was a positive treatment response between Day 3 and Day 5 after anakinra initiation. Secondary outcomes included changes in pain ratings assessed by the visual analogue scales (VAS), C-reactive protein (CRP) levels, tender joint counts (TJCs), swollen joint counts (SJCs), and steroid usage.
RESULTS: Six studies were included in our meta-analysis: five observational studies and one randomized controlled trial. A total of 84 patients were included in our analysis. Subjective physician assessments of clinical response were reported in all studies with a combined positive treatment response rate of 76% (95% CI: 61-86, I2 = 0%). Our pooled analysis also showed a significant reduction of VAS scores by 48.12 mm (95% CI: 53.21-43.03, I2 = 0%) and CRP levels by 62.09 mg/L (95% CI: 97.74-26.44, I2 = 77%) from baseline. Reductions of TJC and SJC were also demonstrated: 4.86 (95% CI: 5.48-4.23, I2 = 0%) and 3.65 (95% CI: -12.53 to 5.22, I2 = 54%), respectively. Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia.
CONCLUSIONS: Anakinra is a promising alternative treatment for patients with acute CPPD flare as it showed desirable clinical responses and a favourable safety profile.