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Anakinra for rheumatoid arthritis: a systematic review
Marty Mertens1, Jasvinder A Singh
1Minneapolis VA Medical Center, Rheumatology (111R), One Veteran's Drive, Minneapolis, MN 55417, USA.
The Journal of Rheumatology
|May 19, 2009
Summary
Anakinra shows modest effectiveness for rheumatoid arthritis (RA) treatment, improving ACR scores and pain. While generally safe, it increased injection site reactions and serious infections, requiring further long-term safety studies.
Area of Science:
- Immunology
- Rheumatology
- Pharmacology
Background:
- Rheumatoid arthritis (RA) is a chronic autoimmune disease characterized by joint inflammation.
- Biologic therapies offer treatment options for RA, with anakinra being an interleukin-1 receptor antagonist.
Purpose of the Study:
- To systematically review the clinical effectiveness and safety of anakinra in rheumatoid arthritis (RA).
Main Methods:
- Systematic review of randomized controlled trials (RCTs) comparing anakinra to placebo in adult RA patients.
- Searched major databases including Cochrane CENTRAL, MEDLINE, EMBASE, and CINAHL.
- Included five trials with 2846 participants.
Main Results:
- Anakinra significantly improved American College of Rheumatology (ACR)20, ACR50, and ACR70 scores compared to placebo.
- Improvements were also observed in Health Assessment Questionnaire, pain scores, radiographic scores, and erythrocyte sedimentation rate.
- No significant differences in overall withdrawals, deaths, or serious adverse events, but increased serious infections (1.8% vs 0.6%) and injection site reactions (71% vs 28%) were noted.
Conclusions:
- Anakinra is a modestly effective biologic therapy for RA with a generally acceptable safety profile.
- Further research is needed to assess long-term safety and compare anakinra's efficacy against other RA therapies.
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