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Anakinra for the Treatment of Hemophagocytic Lymphohistiocytosis: 21 Cases

Title: Anakinra for the Treatment of Hemophagocytic Lymphohistiocytosis: 21 Cases
Authors: Clara Baverez; Maximilien Grall; Mathieu Gerfaud-Valentin; Sarah De Gail; Alexandre Belot; Thomas Perpoint; Emmanuelle Weber; Quitterie Reynaud; Pascal Sève; Yvan Jamilloux
Source: Journal of Clinical Medicine ; Volume 11 ; Issue 19 ; Pages: 5799
Publisher Information: Multidisciplinary Digital Publishing Institute
Publication Year: 2022
Collection: MDPI Open Access Publishing
Subject Terms: anakinra; interleukin-1; hemophagocytic lymphohistiocytosis; adult onset Still’s disease; immunotherapy; cytokines; inflammatory mediators
Description: Hemophagocytic lymphohistiocytosis (HLH) is a life-threatening cytokine storm syndrome. There are no definitive guidelines for the management of secondary HLH (sHLH). A recent report by a National Health Service (NHS) clinical panel has recommended anakinra as a treatment option. We aimed to analyse the efficacy and safety of anakinra for the treatment of all-cause sHLH. We conducted a multicentric retrospective study in two French University hospitals and included all patients who had a diagnosis of sHLH and who received anakinra. Among 21 patients (median age, 45 years), 13 were men. Anakinra was used as first-line therapy in 10 patients, and as monotherapy in 5 patients. We found that anakinra was effective in 19/21 patients (90.5%), with fever resolution in 19 patients (90.5%) within a median of 1.0 day (1, 2). At the Day 7 assessment, the mean CRP concentration decreased significantly (p < 0.001), as did the mean ferritin (p = 0.011). Anakinra was generally safe and well tolerated and was discontinued for side effects in only three patients (14.3%). Anakinra is an efficient and safe treatment to control sHLH of various causes. These data, together with the recent report of the NHS panel, call for the rapid conduct of prospective randomized clinical trials.
Document Type: text
File Description: application/pdf
Language: English
Relation: Immunology & Rheumatology; https://dx.doi.org/10.3390/jcm11195799
DOI: 10.3390/jcm11195799
Availability: https://doi.org/10.3390/jcm11195799
Rights: https://creativecommons.org/licenses/by/4.0/
Accession Number: edsbas.408D507B
Database: BASE