The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome

Abstract Introduction Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) and pyoderma gangrenosum, acne and hidradenitis suppurativa (PASH) are rare autoinflammatory diseases. Treatment of PAPA and PASH is difficult. Conventional immunosuppressants and tumor necrosis factor (TNF) antagonists f...

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Main Authors: Chloé Challamel, Céline Girard, Laurent Misery, Assia Touhouche, Marion Fradet, Maëlla Severino‐Freire, Cristina B. Livideanu, Maria P. Konstantinou, Fatma Jendoubi, Carle Paul
Format: Article
Language:English
Published: Wiley 2022-09-01
Series:JEADV Clinical Practice
Subjects:
Online Access:https://doi.org/10.1002/jvc2.52
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author Chloé Challamel
Céline Girard
Laurent Misery
Assia Touhouche
Marion Fradet
Maëlla Severino‐Freire
Cristina B. Livideanu
Maria P. Konstantinou
Fatma Jendoubi
Carle Paul
author_facet Chloé Challamel
Céline Girard
Laurent Misery
Assia Touhouche
Marion Fradet
Maëlla Severino‐Freire
Cristina B. Livideanu
Maria P. Konstantinou
Fatma Jendoubi
Carle Paul
author_sort Chloé Challamel
collection DOAJ
description Abstract Introduction Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) and pyoderma gangrenosum, acne and hidradenitis suppurativa (PASH) are rare autoinflammatory diseases. Treatment of PAPA and PASH is difficult. Conventional immunosuppressants and tumor necrosis factor (TNF) antagonists fail to control skin lesions in many patients. Materials and Methods We conducted a retrospective observational study of patients treated with interleukin‐1 (IL‐1) antagonists for PAPA or PASH syndrome. We included all PASH and PAPA treated with the IL‐1 antagonists canakinumab and anakinra in Toulouse, Brest and Montpellier, France and report on the patients' response to treatment. Results Four patients were treated with anakinra (one patient) and/or canakinumab (three patients) for 6 months to 10 years. Treatment was associated with sustained improvement of skin lesions: hidradenitis suppurativa in four patients including full resolution of skin lesions in three patients, acne with full resolution in one patient, pyoderma gangrenosum in three patients who experienced full resolution of skin lesions. Anti‐IL‐1 treatment was also associated with full resolution of symptoms associated with spondyloarthritis in one patient. One patient who had been receiving oral corticosteroids for years was able to stop treatment while on IL‐1 antagonist. Discussion IL‐1 antagonists, especially canakinumab, are useful alternatives to treat patients with PAPA or PASH syndrome, especially patients who are non‐responders to conventional treatment and TNF antagonists.
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spelling doaj.art-c812b47fa58a4883b63b801df1dd2e432022-12-22T03:47:21ZengWileyJEADV Clinical Practice2768-65662022-09-011327528010.1002/jvc2.52The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndromeChloé Challamel0Céline Girard1Laurent Misery2Assia Touhouche3Marion Fradet4Maëlla Severino‐Freire5Cristina B. Livideanu6Maria P. Konstantinou7Fatma Jendoubi8Carle Paul9Department of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU de Montpellier Montpellier FranceDepartment of Dermatology CHU de Brest Brest FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceDepartment of Dermatology CHU and Université de Toulouse Toulouse FranceAbstract Introduction Pyogenic arthritis, pyoderma gangrenosum and acne (PAPA) and pyoderma gangrenosum, acne and hidradenitis suppurativa (PASH) are rare autoinflammatory diseases. Treatment of PAPA and PASH is difficult. Conventional immunosuppressants and tumor necrosis factor (TNF) antagonists fail to control skin lesions in many patients. Materials and Methods We conducted a retrospective observational study of patients treated with interleukin‐1 (IL‐1) antagonists for PAPA or PASH syndrome. We included all PASH and PAPA treated with the IL‐1 antagonists canakinumab and anakinra in Toulouse, Brest and Montpellier, France and report on the patients' response to treatment. Results Four patients were treated with anakinra (one patient) and/or canakinumab (three patients) for 6 months to 10 years. Treatment was associated with sustained improvement of skin lesions: hidradenitis suppurativa in four patients including full resolution of skin lesions in three patients, acne with full resolution in one patient, pyoderma gangrenosum in three patients who experienced full resolution of skin lesions. Anti‐IL‐1 treatment was also associated with full resolution of symptoms associated with spondyloarthritis in one patient. One patient who had been receiving oral corticosteroids for years was able to stop treatment while on IL‐1 antagonist. Discussion IL‐1 antagonists, especially canakinumab, are useful alternatives to treat patients with PAPA or PASH syndrome, especially patients who are non‐responders to conventional treatment and TNF antagonists.https://doi.org/10.1002/jvc2.52anakinraCanakinumabPAPA syndromePyoderma gangrenosum
spellingShingle Chloé Challamel
Céline Girard
Laurent Misery
Assia Touhouche
Marion Fradet
Maëlla Severino‐Freire
Cristina B. Livideanu
Maria P. Konstantinou
Fatma Jendoubi
Carle Paul
The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
JEADV Clinical Practice
anakinra
Canakinumab
PAPA syndrome
Pyoderma gangrenosum
title The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
title_full The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
title_fullStr The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
title_full_unstemmed The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
title_short The efficacy of anti‐IL‐1 targeted therapy in PAPA and PASH syndrome
title_sort efficacy of anti il 1 targeted therapy in papa and pash syndrome
topic anakinra
Canakinumab
PAPA syndrome
Pyoderma gangrenosum
url https://doi.org/10.1002/jvc2.52
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