Rheumatoid arthritis drug may reduce inflammation after stroke

Research into the use of an anti-arthritic drug to reduce brain injury following an ischemic stroke has shown promise; however, further research is needed.

3D CT scan of a person with a stroke

The pro-inflammatory cytokine interleukin (IL)-1 plays a significant role in brain injury following ischemic stroke by inducing peripheral inflammatory mediators, such as IL-6. However, pre-clinical studies show its effects are reduced by the IL-1 receptor antagonist (IL-1Ra).

Researchers investigated the effects of a drug form of IL-1Ra (anakinra), used to treat rheumatoid arthritis, on acute ischemic stroke through a double-blind, randomised controlled trial[1]
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The drug was administered subcutaneously, 100mg twice daily for 3 days, in 80 patients presenting within 5 hours of ischemic stroke onset. Levels of IL-6 and other plasma inflammatory markers were analysed at five time points, before, during and after treatment.

It was found that, over the three days, IL-1Ra significantly reduced levels of IL-6 and other inflammatory mediators.

IL-1Ra was found to be safe and well-tolerated, the researchers concluded in Stroke (22 March 2018). However, further experimental studies are required to investigate possible interactions with thrombolytic agents.

References

[1] Smith C, Hulme S, Vail A et  al. Subcutaneous interleukin-1 receptor antagonist in ischemic stroke (SCIL-STROKE): a randomized controlled phase 2 trial. Stroke 2018. doi: 10.1161/STROKEAHA.118.020750

Last updated
Citation
Clinical Pharmacist, CP, June 2018, Vol 10, No 6;10(6):DOI:10.1211/PJ.2018.20204800