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IL-1 Inhibition in CPPD

Jack Cush, MD
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Controlled clinical trials in patients with calcium Pyrophosphate Deposition Disease (CPPD) are scant. Now a metanalysis provides evidence that anakinra, an interleukin-1 inhibitor, is a promising alternative for patients with acute CPPD flares.

The purpose of this analysis is that CPPD preferentially affects older adults; and their comorbidities often limit conventional treatment options. 

The metanalysis included 6 studies and 84 patients – from 5 observational and 1 randomized controlled trial.  Efficacy of anakinra was suggested by: 

  • Subjective physician assessments with a positive clinical response rate of 76% 
  • Significant reduction of VAS scores by -48.12 mm (0-100 scale) 
  • Significant reduction in CRP levels by – 62.09 mg/L from baseline. 
  • Reduced TJC (-4.86) and SJC (-3.65)

Adverse reactions included injection site reaction, rash, bacterial pneumonitis, and neutropenia.

Anakinra appears to be effective in acute CPPD flares with a favourable safety profile.

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