@article{discovery1567630,
          volume = {24},
            note = {This version is the author accepted manuscript. For information on re-use, please refer to the publisher's terms and conditions.},
           pages = {189--193},
          number = {3},
           month = {September},
           title = {Safety and efficacy of empirical interleukin-1 inhibition using anakinra in AA amyloidosis of uncertain aetiology},
            year = {2017},
         journal = {Amyloid},
             url = {http://doi.org/10.1080/13506129.2017.1352503},
            issn = {1744-2818},
          author = {Lane, T and Wechalekar, AD and Gillmore, JD and Hawkins, PN and Lachmann, HJ},
        abstract = {OBJECTIVE: AA amyloidosis is a serious complication of persistent inflammation, which, untreated will progress to renal failure and death. Effective suppression of the underlying inflammatory disease is the focus of treatment. However, in approximately 20\% of cases the underlying condition remains uncertain, presenting a dilemma as to choice of treatment. METHODS: We conducted a retrospective study of a cohort of 11 patients diagnosed with AA amyloidosis of unknown aetiology, who had been empirically treated with anakinra. RESULTS: In anakinra-responders, median pre-treatment SAA was 74 (IQR 34-190) mg/L, and median on-treatment SAA was 6 (4-16) mg/L (p = .0047), with the response having been maintained for a median on-treatment follow-up of 1.8 (1-7.6) years. Six dialysis patients were treated effectively and safely with 100 mg anakinra three times weekly post-dialysis. Four patients remained well on daily anakinra post-renal transplant. Five anakinra-responders showed regression and three showed stabilization of amyloid load on serial SAP scintigraphy. CONCLUSIONS: This small cohort shows that even in potentially high risk cases with organ damage secondary to AA amyloidosis or in the presence of a renal graft, anakinra, when used appropriately and carefully monitored, has proved remarkably effective and well tolerated. Longer follow-up of this off-label use is required.},
        keywords = {AA amyloidosis, anakinra, dialysis, interleukin-1, renal transplant}
}