Multiple drugs
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Multiple drugs Lack of efficacy, redness and inflammatory reaction at the injection site and off-label use of anakinra: case report
An adult woman [age not stated] experienced lack of efficacy following treatment with methotrexate, hydroxychloroquine, dapsone, unspecified antihistamines and unspecified corticosteroids for Schnitzler’s syndrome. At the age of 57 years, she developed redness and inflammatory reaction at the injection site following off-label treatment with anakinra for Schnitzler’s syndrome [not all routes and dosages stated]. The woman, who had had a history of osteoarthritis of the left knee, presented at the age of 57 years for further management of urticarial exanthema on the torso and lower limbs. Initially, she had been diagnosed as idiopathic urticated vasculitis and treated with unspecified antihistamines, unspecified corticosteroids, hydroxychloroquine, methotrexate and dapsone; however, none of these treatments were effective. Treatment with colchicine was ultimately offered and was maintained for 6 years (from 2013 to 2019) during which her complaints were only partially relieved. On presentation, a final diagnosis of Schnitzler’s syndrome was made based on the evidence of urticaria, the IgM Kappa monoclonal gammopathy, as well as the bone pain and the persistent inflammatory syndrome. In February 2020, she was given off-label treatment with SC injection of anakinra 100mg once daily. However, she developed redness and inflammatory reaction at the injection site [time to reaction onset not stated]. The redness and inflammatory reaction at the injection site spontaneously resolved. Since the initiation of anakinra, the woman showed a significant improvement in the Schnitzler’s syndrome. Ilbert C, et al. [Schnitzler syndrome]. Revue Medicale de Liege 75: 553-557, No. 7, Jul 2020. Available from: URL: https://www.rmlg.ulg.ac.be/ index.php?page=listeArt?date=2020%20Jul&langue=FR [French; summarised from a translation]
0114-9954/20/1824-0001/$14.95 Adis © 2020 Springer Nature Switzerland AG. All rights reserved
803505130
Reactions 3 Oct 2020 No. 1824
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