Successful therapy with anakinra in a patient with generalized pustular psoriasis carryingIL36RNmutations

Abstract

U.H. and M.W. contributed equally to this work. Funding sources: none. Conflicts of interest: R.M. and M.P.S. have received payments for conduction of clinical trials, as invited speaker or advisor, or for travel grants from the following companies: Abbott GmbH & Co. KG, Biogen IDEC GmbH, Essex Pharma GmbH, Janssen‐Cilag, LEO Pharma GmbH, Merck Serono GmbH, Novartis Pharma GmbH, Pfizer GmbH and Wyeth Pharma GmbH. M.P.S. has received research grants from Abbott and BiogenIdec, and has received consulting fees from Abbott, BiogenIdec, Janssen‐Cilag, LEO Pharma, Novartis Pharma and Pfizer. Dear Editor, Generalized pustular psoriasis (GPP) may be caused by homozygous or compound heterozygous mutations in the gene IL36RN, which codes for interleukin‐36 receptor antagonist (IL‐36Ra).1 2 Such mutations are present in approximately 40% of patients with GPP in Germany.3 Anakinra, an interleukin (IL)‐1 receptor antagonist, has been described as an effective treatment against GPP in several cases.4 However, there are no published data on whether anakinra is also effective in the subgroup of patients with GPP carrying IL36RN mutations. Here, we report the first case of a patient with GPP carrying IL36RN mutations who responded well to therapy with anakinra.