Anakinra for the treatment of undifferentiated systemic auto-inflammatory disease

Systemic auto-inflammatory diseases (SAID) encompass a range of rare and heterogeneous diseases of difficult diagnosis. They are result from innate dysregulation in the control of inflammatory process, leading to overproduction of proinflammatory cytokines, such as IL-1. The most widely used treatments are corticosteroids and colchicine, although some patients are refractory to them. The introduction of biological drugs ("biologics») designed to inhibit specific components of the inflammatory response, is presented as a therapeutic alternative in these patients. We present the case of a man who was diagnosed with SAID and showed no response to treatment with colchicine and prednisone for whom anakinra was requested for an indication other than those approved in the summary of product characteristics (off-label). After review of the case, the patient began treatment with subcutaneous injections of anakinra 100 mg every 24 hours. At thirty-five months of initiation of anakinra, the patient is still receiving the initial dosing regimen and the treatment remains both effective and well tolerated, the only adverse reaction reported being a reaction at the injection site in the first month