About: Silencing the cytokine storm: the use of intravenous anakinra in haemophagocytic lymphohistiocytosis or macrophage activation syndrome

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About: Silencing the cytokine storm: the use of intravenous anakinra in haemophagocytic lymphohistiocytosis or macrophage activation syndrome Goto Sponge NotDistinct Permalink

An Entity of Type : schema:ScholarlyArticle, within Data Space : wasabi.inria.fr associated with source document(s)

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type	Academic Article research paper schema:ScholarlyArticle
isDefinedBy	Covid-on-the-Web dataset
has title	Silencing the cytokine storm: the use of intravenous anakinra in haemophagocytic lymphohistiocytosis or macrophage activation syndrome
Creator	Mehta, Puja Cron, Randy Hartwell, James Manson, ( Manson, Jessica Mehta, P Mpharm, Hartwell Tattersall, Rachel
Source	Elsevier; Medline; PMC
abstract	The term cytokine storm syndromes describes conditions characterised by a life-threatening, fulminant hypercytokinaemia with high mortality. Cytokine storm syndromes can be genetic or a secondary complication of autoimmune or autoinflammatory disorders, infections, and haematological malignancies. These syndromes represent a key area of interface between rheumatology and general medicine. Rheumatologists often lead in management, in view of their experience using intensive immunosuppressive regimens and managing cytokine storm syndromes in the context of rheumatic disorders or infection (known as secondary haemophagocytic lymphohistiocytosis or macrophage activation syndrome [sHLH/MAS]). Interleukin (IL)-1 is pivotal in hyperinflammation. Anakinra, a recombinant humanised IL-1 receptor antagonist, is licenced at a dose of 100 mg once daily by subcutaneous injection for rheumatoid arthritis, systemic juvenile idiopathic arthritis, adult-onset Still's disease, and cryopyrin-associated periodic syndromes. In cytokine storm syndromes, the subcutaneous route is often problematic, as absorption can be unreliable in patients with critical illness, and multiple injections are needed to achieve the high doses required. As a result, intravenous anakinra is used in clinical practice for sHLH/MAS, despite this being an off-licence indication and route of administration. Among 46 patients admitted to our three international, tertiary centres for sHLH/MAS and treated with anakinra over 12 months, the intravenous route of delivery was used in 18 (39%) patients. In this Viewpoint, we describe current challenges in the management of cytokine storm syndromes and review the pharmacokinetic and safety profile of intravenous anakinra. There is accumulating evidence to support the rationale for, and safety of, intravenous anakinra as a first-line treatment in patients with sHLH/MAS. Intravenous anakinra has important clinical relevance when high doses of drug are required or if patients have subcutaneous oedema, severe thrombocytopenia, or neurological involvement. Cross-speciality management and collaboration, with the generation of international, multi-centre registries and biobanks, are needed to better understand the aetiopathogenesis and improve the poor prognosis of cytokine storm syndromes.
has issue date	2020-05-04(xsd:dateTime)
bibo:doi	10.1016/s2665-9913(20)30096-5
bibo:pmid	32373790
has license	no-cc
sha1sum (hex)	02981925fc9330abbf43819272523df61ebdc7d6
schema:url	https://doi.org/10.1016/s2665-9913%2820%2930096-5
resource representing a document's title	Silencing the cytokine storm: the use of intravenous anakinra in haemophagocytic lymphohistiocytosis or macrophage activation syndrome
has PubMed Central identifier	PMC7198216
has PubMed identifier	32373790
schema:publication	Lancet Rheumatol
resource representing a document's body	covid:02981925fc9330abbf43819272523df61ebdc7d6#body_text
is schema:about of	named entity 'secondary' named entity 'route' named entity 'injections' named entity 'absorption' named entity 'first-line treatment' named entity 'Intravenous' named entity 'problematic' named entity 'syndromes' named entity 'generation' named entity 'improve' named entity 'critical illness' named entity 'humanised' named entity 'patients' named entity 'SYNDROMES' named entity 'INFECTIONS' named entity 'INFECTION' named entity 'RESULT' named entity 'USING' named entity 'HYPERCYTOKINAEMIA' named entity 'LICENCE' named entity 'CURRENT' named entity 'LIFE' named entity 'EVIDENCE' named entity 'SUBCUTANEOUS OEDEMA' named entity 'CHALLENGES' named entity 'GENERAL MEDICINE' named entity 'REQUIRED' named entity 'TREATED WITH' named entity 'CONTEXT' named entity 'ROUTE OF ADMINISTRATION' named entity 'HIGH' named entity 'VIEWPOINT' named entity 'BETTER' named entity 'IMMUNOSUPPRESSIVE' named entity 'AREA' named entity 'CROSS' named entity 'ADULT-ONSET' named entity 'multiple' named entity 'periodic' named entity 'evidence' named entity 'MAS' named entity 'daily' named entity 'These' named entity 'high' named entity 'Still' named entity 'intravenous' named entity 'syndromes' named entity 'autoimmune' named entity 'mortality' named entity 'safety' named entity 'managing' named entity 'haematological malignancies' named entity 'tertiary' named entity 'drug' named entity 'rheumatology' named entity 'Silencing' named entity 'sHLH' named entity 'rheumatoid arthritis' named entity 'route of administration' named entity 'sHLH' named entity 'Interleukin' named entity 'anakinra' named entity 'Rheumatologists' named entity 'macrophage activation syndrome' named entity 'haemophagocytic lymphohistiocytosis' named entity 'immunosuppressive regimens' named entity 'MAS' named entity 'intravenous' named entity 'subcutaneous' named entity 'thrombocytopenia' named entity 'Anakinra' named entity 'haematological malignancies' named entity 'biobanks' named entity 'anakinra'

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