Open AccessTowards a Treatment for Neuroinflammation in Epilepsy: Interleukin-1 Receptor Antagonist, Anakinra, as a Potential Treatment in Intractable Epilepsy
Author(s) -
Gaku Yamanaka,
Yu Ishida,
Kanako Kanou,
Shinji Suzuki,
Yusuke Watanabe,
Tomoko Takamatsu,
Shinichiro Morıchı,
Soken Go,
Shingo Oana,
Takashi Yamazaki,
Hisashi Kawashima
Publication year - 2021
Publication title -
international journal of molecular sciences
Language(s) - English
Resource type - Journals
SCImago Journal Rank - 1.455
H-Index - 162
eISSN - 1661-6596
pISSN - 1422-0067
DOI - 10.3390/ijms22126282
Subject(s) - anakinra , medicine , epilepsy , interleukin 1 receptor antagonist , neuroinflammation , antagonist , anticonvulsant , discontinuation , epileptogenesis , anesthesia , receptor antagonist , receptor , inflammation , disease , psychiatry
Febrile Infection-Related Epilepsy Syndrome (FIRES) is a unique catastrophic epilepsy syndrome, and the development of drug-resistant epilepsy (DRE) is inevitable. Recently, anakinra, an interleukin-1 receptor antagonist (IL-1RA), has been increasingly used to treat DRE due to its potent anticonvulsant activity. We here summarized its effects in 38 patients (32 patients with FIRES and six with DRE). Of the 22 patients with FIRES, 16 (73%) had at least short-term seizure control 1 week after starting anakinra, while the remaining six suspected anakinra-refractory cases were male and had poor prognoses. Due to the small sample size, an explanation for anakinra refractoriness was not evident. In all DRE patients, seizures disappeared or improved, and cognitive function improved in five of the six patients following treatment. Patients showed no serious side effects, although drug reactions with eosinophilia and systemic symptoms, cytopenia, and infections were observed. Thus, anakinra has led to a marked improvement in some cases, and functional deficiency of IL-1RA was indicated, supporting a direct mechanism for its therapeutic effect. This review first discusses the effectiveness of anakinra for intractable epileptic syndromes. Anakinra could become a new tool for intractable epilepsy treatment. However, it does not currently have a solid evidence base.