Intravenous administration of anakinra in children with macrophage activation syndrome

Abstract Background Subcutaneous anakinra is an interleukin-1 inhibitor used to treat juvenile idiopathic arthritis. Recent reports suggest anakinra can be a valuable addition to the treatment of COVID-19 associated cytokine storm syndrome and the related multisystem inflammatory syndrome (MIS-C) in...

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Main Authors: Omkar Phadke, Kelly Rouster-Stevens, Helen Giannopoulos, Shanmuganathan Chandrakasan, Sampath Prahalad
Format: Article
Language:English
Published: BMC 2021-06-01
Series:Pediatric Rheumatology Online Journal
Online Access:https://doi.org/10.1186/s12969-021-00585-3
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spelling doaj-1ffc25f685f544d08453b5bebe264b162021-07-04T11:05:29ZengBMCPediatric Rheumatology Online Journal1546-00962021-06-011911510.1186/s12969-021-00585-3Intravenous administration of anakinra in children with macrophage activation syndromeOmkar Phadke0Kelly Rouster-Stevens1Helen Giannopoulos2Shanmuganathan Chandrakasan3Sampath Prahalad4Department of Pediatrics, Emory University School of MedicineDepartment of Pediatrics, Emory University School of MedicineChildren’s Healthcare of AtlantaDepartment of Pediatrics, Emory University School of MedicineDepartment of Pediatrics, Emory University School of MedicineAbstract Background Subcutaneous anakinra is an interleukin-1 inhibitor used to treat juvenile idiopathic arthritis. Recent reports suggest anakinra can be a valuable addition to the treatment of COVID-19 associated cytokine storm syndrome and the related multisystem inflammatory syndrome (MIS-C) in children. Herein, we describe our experience with intravenously administered anakinra. Findings 19 Patients (9 male) received intravenous (IV) anakinra for treatment of macrophage activation syndrome (MAS) secondary to systemic lupus erythematosus (SLE), systemic JIA (SJIA) or secondary hemophagocytic lymphohistiocytosis (sHLH). In most cases the general trend of the fibrinogen, ferritin, AST, and platelet count (Ravelli criteria) improved after initiation of IV anakinra. There were no reports of anaphylaxis or reactions associated with administration of IV anakinra. Conclusion Intravenous administration of anakinra is an important therapeutic option for critically ill patients with MAS/HLH. It is also beneficial for those with thrombocytopenia, subcutaneous edema, neurological dysfunction, or very young, hospitalized patients who need multiple painful subcutaneous injections.https://doi.org/10.1186/s12969-021-00585-3
collection DOAJ
language English
format Article
sources DOAJ
author Omkar Phadke
Kelly Rouster-Stevens
Helen Giannopoulos
Shanmuganathan Chandrakasan
Sampath Prahalad
spellingShingle Omkar Phadke
Kelly Rouster-Stevens
Helen Giannopoulos
Shanmuganathan Chandrakasan
Sampath Prahalad
Intravenous administration of anakinra in children with macrophage activation syndrome
Pediatric Rheumatology Online Journal
author_facet Omkar Phadke
Kelly Rouster-Stevens
Helen Giannopoulos
Shanmuganathan Chandrakasan
Sampath Prahalad
author_sort Omkar Phadke
title Intravenous administration of anakinra in children with macrophage activation syndrome
title_short Intravenous administration of anakinra in children with macrophage activation syndrome
title_full Intravenous administration of anakinra in children with macrophage activation syndrome
title_fullStr Intravenous administration of anakinra in children with macrophage activation syndrome
title_full_unstemmed Intravenous administration of anakinra in children with macrophage activation syndrome
title_sort intravenous administration of anakinra in children with macrophage activation syndrome
publisher BMC
series Pediatric Rheumatology Online Journal
issn 1546-0096
publishDate 2021-06-01
description Abstract Background Subcutaneous anakinra is an interleukin-1 inhibitor used to treat juvenile idiopathic arthritis. Recent reports suggest anakinra can be a valuable addition to the treatment of COVID-19 associated cytokine storm syndrome and the related multisystem inflammatory syndrome (MIS-C) in children. Herein, we describe our experience with intravenously administered anakinra. Findings 19 Patients (9 male) received intravenous (IV) anakinra for treatment of macrophage activation syndrome (MAS) secondary to systemic lupus erythematosus (SLE), systemic JIA (SJIA) or secondary hemophagocytic lymphohistiocytosis (sHLH). In most cases the general trend of the fibrinogen, ferritin, AST, and platelet count (Ravelli criteria) improved after initiation of IV anakinra. There were no reports of anaphylaxis or reactions associated with administration of IV anakinra. Conclusion Intravenous administration of anakinra is an important therapeutic option for critically ill patients with MAS/HLH. It is also beneficial for those with thrombocytopenia, subcutaneous edema, neurological dysfunction, or very young, hospitalized patients who need multiple painful subcutaneous injections.
url https://doi.org/10.1186/s12969-021-00585-3
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