LETTER
A patient’s wish: anakinra in pregnancy
1 Immunology Clinic, Department of Internal Medicine, University Hospital Zurich, Zurich, Switzerland
2 Immunologie-Zentrum Zürich, Zurich, Switzerland
Correspondence to:
Correspondence to Dr T Hauser, Immunologie-Zentrum Zürich, Walchestrasse 11, 8006 Zurich, Switzerland; hauser@immunologie-zentrum.ch
Accepted 3 March 2009
| The first 150 words of the full text of this article appear below. |
Patients with adult-onset Still’s disease (AOSD) are at increased risk for adverse outcomes of pregnancy. An increased rate of preterm birth, intrauterine growth retardation and a possible influence of disease activity on pregnancy outcome have been reported.1 Interleukin 1 (IL1) is thought to have a key role in the pathogenesis of AOSD. Interestingly, it has also been related to an increased risk of preterm birth in animal models.2 3 An increasing number of reports on treatment of refractory AOSD with IL1 receptor antagonist (anakinra) emphasise its dramatic therapeutic effect and the rarity of its adverse events.4 5 However, its effects in pregnancy are not well known. Here we report successful continuous treatment of AOSD during pregnancy and breastfeeding.
A 33-year-old woman with AOSD currently treated with recombinant IL1 receptor antagonist (IL1ra, anakinra) expressed the wish to become pregnant. Her disease course was refractory to treatment with prednisone alone or in combination with
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