Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease

Sarah A. Taylor, Jennifer M. Vittorio, Mercedes Martinez, Keith A. Fester, Stephen M. Lagana, Steven J. Lobritto, Nadia Ovchinsky

Research output: Contribution to journalArticle

6 Citations (Scopus)

Abstract

The interleukin-1 (IL-1) family consists of 11 cytokines that play key regulatory roles in many immune and inflammatory processes. Anakinra (Kineret, Amgen, Inc.) is an IL-1 receptor antagonist (IL-1ra). Increased levels of IL-1 are found in several disease states suggesting that anakinra may be beneficial in disorders associated with elevated IL-1 levels. Anakinra has been effectively used in the treatment of systemic juvenile idiopathic arthritis and adult-onset Still's disease (AOSD). Despite its therapeutic benefits, anakinra also has potential side effects, including hepatotoxicity. We present a case of AOSD in an adolescent male that was treated with anakinra. During treatment, the patient developed acute liver failure that resolved upon withdrawal of anakinra. Although anakinra-induced liver injury has been reported in adults, including one case of subacute liver failure, we believe our case is the first to show severe acute liver failure in an adolescent treated with anakinra. This case provides significant insight into a potentially serious complication associated with anakinra. It is important to further delineate these complications as the treatment indications for this drug expand.

Original languageEnglish (US)
Pages (from-to)e1-e4
JournalPharmacotherapy
Volume36
Issue number1
DOIs
StatePublished - Jan 1 2016

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Interleukin 1 Receptor Antagonist Protein
Acute Liver Failure
Adult-Onset Still's Disease
Interleukin-1
Interleukin-1 Receptors
Juvenile Arthritis
Liver Failure
Therapeutics
Cytokines

Keywords

  • adult onset Still's disease
  • anakinra
  • drug-induced liver injury
  • liver failure

ASJC Scopus subject areas

  • Pharmacology (medical)

Cite this

Taylor, S. A., Vittorio, J. M., Martinez, M., Fester, K. A., Lagana, S. M., Lobritto, S. J., & Ovchinsky, N. (2016). Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease. Pharmacotherapy, 36(1), e1-e4. https://doi.org/10.1002/phar.1677

Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease. / Taylor, Sarah A.; Vittorio, Jennifer M.; Martinez, Mercedes; Fester, Keith A.; Lagana, Stephen M.; Lobritto, Steven J.; Ovchinsky, Nadia.

In: Pharmacotherapy, Vol. 36, No. 1, 01.01.2016, p. e1-e4.

Research output: Contribution to journalArticle

Taylor, SA, Vittorio, JM, Martinez, M, Fester, KA, Lagana, SM, Lobritto, SJ & Ovchinsky, N 2016, 'Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease', Pharmacotherapy, vol. 36, no. 1, pp. e1-e4. https://doi.org/10.1002/phar.1677
Taylor SA, Vittorio JM, Martinez M, Fester KA, Lagana SM, Lobritto SJ et al. Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease. Pharmacotherapy. 2016 Jan 1;36(1):e1-e4. https://doi.org/10.1002/phar.1677
Taylor, Sarah A. ; Vittorio, Jennifer M. ; Martinez, Mercedes ; Fester, Keith A. ; Lagana, Stephen M. ; Lobritto, Steven J. ; Ovchinsky, Nadia. / Anakinra-Induced Acute Liver Failure in an Adolescent Patient with Still's Disease. In: Pharmacotherapy. 2016 ; Vol. 36, No. 1. pp. e1-e4.
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