Weiss Memorial Hospital Chicago, IL, United States
Disclosure(s): No financial relationships with ineligible companies to disclose
Background/Purpose: 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 analog scales (VAS), C-reactive protein levels, tender joint counts (TJC), swollen joint counts (SJC) and corticosteroid 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: -12.53-5.22, I²=54%), respectively. Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia. Conclusion: Anakinra is a promising alternative treatment for patients with acute CPPD flare as it showed desirable clinical responses and a favorable safety profile.
