Ostendorf B, Iking-Konert C, Kurz K, Jung G, Sander O, Schneider M
Department of Endocrinology, Diabetology and Rheumatology, Heinrich-Heine-University Duesseldorf, 40225 Düsseldorf, Germany.
Ann Rheum Dis. 2005 Apr;64(4):630-3. doi: 10.1136/ard.2004.025858. Epub 2004 Sep 2.
Joint involvement occurs in most patients with systemic lupus erythematosus (SLE), and severe lupus arthritis is often refractory to conventional treatments. Anakinra is used in the treatment of rheumatoid arthritis, but its therapeutic potential has not been proved in patients with SLE.
To determine the safety/tolerability and efficacy of anakinra in patients with SLE with leading joint involvement.
In patients with SLE with active polyarthritis and no other uncontrolled systemic/organ manifestations, 100 mg/day anakinra was self administered subcutaneously for 3 months. Disease activity was assessed by VAS, number of swollen/tender joints, ECLAM score, and serological and immunological measures.
Four patients with SLE were studied; anakinra was safe in all four patients and no drug related serious adverse events occurred. A subjective benefit was seen in all patients and a trend towards better activity measures after 4 weeks. After an initial response, one patient left the study because of an arthritic flare after 6 weeks.
In this study anakinra was apparently safe and well tolerated and led to clinical and serological improvement. Anakinra might be an interesting alternative in individual patients with lupus arthritis not responding to conventional treatments.
大多数系统性红斑狼疮（SLE）患者会出现关节受累，严重的狼疮性关节炎通常对传统治疗无效。阿那白滞素用于治疗类风湿性关节炎，但其对SLE患者的治疗潜力尚未得到证实。
确定阿那白滞素对以关节受累为主的SLE患者的安全性/耐受性及疗效。
对于患有活动性多关节炎且无其他未控制全身/器官表现的SLE患者，皮下自行注射阿那白滞素100mg/天，持续3个月。通过视觉模拟评分法（VAS）、肿胀/压痛关节数、欧洲抗风湿病联盟（EULAR）评分以及血清学和免疫学指标评估疾病活动度。
研究了4例SLE患者；阿那白滞素在所有4例患者中均安全，未发生与药物相关的严重不良事件。所有患者均有主观改善，4周后疾病活动度指标有改善趋势。在最初有反应后，1例患者在6周时因关节炎复发退出研究。
在本研究中，阿那白滞素显然安全且耐受性良好，并导致临床和血清学改善。对于对传统治疗无反应的狼疮性关节炎个体患者，阿那白滞素可能是一种有吸引力的替代治疗方法。
