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Anakinra effectively treated severe hidradenitis suppurativa

Anakinra, a recombinant interleukin 1 receptor antagonist, was effective in treating severe hidradenitis suppurativa compared with placebo, according to study results recently published in JAMA Dermatology.

Researchers conducted a double-blind study of 20 patients with Hurley stage II or III hidradenitis suppurativa (HS) between March 1, 2012, and Feb. 28, 2014, at Attikon University General Hospital in Athens, Greece. Randomized treatment (10 patients each) consisted of subcutaneous injections from identical syringes containing placebo or anakinra once daily for 12 weeks. There also was a 12-week follow-up.

The researchers isolated peripheral blood mononuclear cells prior to the beginning of treatment, at week 12 and week 24. The cells were stimulated for cytokine production.

One patient in the anakinra arm was lost to follow-up. Mean age was 42.8 years for the remaining nine patients in the anakinra arm and 36 years for the 10 patients in the placebo arm. There was a 67% decrease in disease activity score patients in the anakinra arm compared with a 20% decrease in the placebo arm (P =. 04).

In the anakinra arm, 78% of patients achieved HS clinical response at week 12 compared with 30% of patients in the placebo arm (P = .04).

There was decreased production of interferon-y by peripheral blood mononuclear cells and an increase in interleukin 22 in the anakinra arm. Also, the anakinra arm had a prolonged time to new HS exacerbation when compared with the placebo cohort, according to log-rank test (P = .01). Serious adverse events were not reported.

“The results indicate that anakinra attenuates the severity of HS,” the researchers wrote. “Most of the clinical efficacy of anakinra was shown from week 8 onward.”

“Anakinra therapy was safe in patients with HS,” the researchers concluded. “Injection site pain and mild infection reported herein are within the drug safety profile. Despite the few enrolled patients, the results of anakinra use to treat HS are promising.” – by Bruce Thiel

Disclosure: Tzanetakou reports no relevant financial disclosures. Please see the full study for a list of other researchers’ relevant financial disclosures.