Anakinra significantly reduced the recurrence of pericarditis to 18% compared to 90% with placebo in patients with refractory idiopathic recurrent pericarditis.
Does interleukin-1 inhibition with anakinra improve outcomes in patients with refractory idiopathic recurrent pericarditis?
Interleukin-1 inhibition with anakinra is highlighted as a highly effective and safe steroid-sparing therapy for refractory idiopathic recurrent pericarditis.
Recurrent pericarditis is a common complication of acute pericarditis (15-30%) for which, in most cases, no underlying etiology is found idiopathic recurrent pericarditis (IRP). IRP is currently viewed as an autoinflammatory disease with characteristic recurrent episodes of sterile inflammation. According to the most recent Guidelines, the initial treatment regimen consists of a combination of aspirin or non-steroidal anti-inflammatory drugs with colchicine followed by the addition of corticosteroids in resistant or intolerant cases. Despite this treatment approach, a number of patients either do not respond or cannot tolerate the above therapies. For this refractory group, small case series and a recent randomized controlled trial have shown that interleukin-1 inhibition with anakinra is a rapidly acting, highly efficient, steroid-sparing, and safe therapeutic intervention. In this perspective, we discuss the available clinical evidence and our own clinical experience as well as the future prospects of this novel therapeutic approach for patients with IRP.
Lazaros et al. (Sun,) conducted a review in Idiopathic Recurrent Pericarditis. Anakinra vs. Placebo / Standard of care was evaluated. Anakinra significantly reduced the recurrence of pericarditis to 18% compared to 90% with placebo in patients with refractory idiopathic recurrent pericarditis.