A pilot study of IL-1 inhibition by anakinra in acute gout

Arthritis Res Ther. 2007;9(2):R28. doi: 10.1186/ar2143.


Monosodium urate crystals stimulate monocytes and macrophages to release IL-1beta through the NALP3 component of the inflammasome. The effectiveness of IL-1 inhibition in hereditary autoinflammatory syndromes with mutations in the NALP3 protein suggested that IL-1 inhibition might also be effective in relieving the inflammatory manifestations of acute gout. The effectiveness of IL-1 inhibition was first evaluated in a mouse model of monosodium urate crystal-induced inflammation. IL-1 inhibition prevented peritoneal neutrophil accumulation but TNF blockade had no effect. Based on these findings, we performed a pilot, open-labeled study (trial registration number ISRCTN10862635) in 10 patients with gout who could not tolerate or had failed standard antiinflammatory therapies. All patients received 100 mg anakinra daily for 3 days. All 10 patients with acute gout responded rapidly to anakinra. No adverse effects were observed. IL-1 blockade appears to be an effective therapy for acute gouty arthritis. The clinical findings need to be confirmed in a controlled study.

Publication types

  • Case Reports
  • Clinical Trial

MeSH terms

  • Adult
  • Aged
  • Animals
  • Arthritis, Gouty / drug therapy*
  • Chemotaxis, Leukocyte / drug effects
  • Female
  • Humans
  • Interleukin 1 Receptor Antagonist Protein / therapeutic use*
  • Interleukin-1 / metabolism*
  • Male
  • Mice
  • Middle Aged
  • Peritonitis / chemically induced
  • Peritonitis / drug therapy
  • Pilot Projects
  • Uric Acid / toxicity


  • Interleukin 1 Receptor Antagonist Protein
  • Interleukin-1
  • Uric Acid

Associated data

  • ISRCTN/ISRCTN10862635