Martina Finetti1, Antonella Insalaco2, Luca Cantarini3, Antonella Meini4, Luciana Breda5, Maria Alessio6, Matteo D'Alessandro1, Paolo Picco1, Alberto Martini7, Marco Gattorno8. 1. UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy. 2. Ospedale Pediatrico Bambino Gesù, Rome, Italy. 3. Policlinico Le Scotte, Università di Siena, Siena, Italy. 4. Spedali Civili di Brescia, Brescia, Italy. 5. Ospedale Policlinico Chieti, Chieti, Italy. 6. Università Federico II, Napoli, Italy. 7. UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy; Università di Genoa, Genoa, Italy. 8. UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy. Electronic address: marcogattorno@ospedale-gaslini.ge.it.
Abstract
OBJECTIVE: To evaluate the long-term response and safety of interleukin-1 receptor antagonist (anakinra) in recurrent pericarditis. STUDY DESIGN: Fifteen patients (12 children, 3 adults) were enrolled in a multicenter retrospective study. All the patients were corticosteroid-dependent and 14 had received colchicine. Anakinra was given at 1-2 mg/kg/d. The primary outcome of the study was a reduction of at least 70% of disease flares after anakinra treatment compared with the pretreatment period. Secondary outcomes were: (1) number of complete or partial responders to anakinra and time for complete response; (2) number of patients who discontinued other ongoing treatments (non-steroidal anti-inflammatory drugs, corticosteroid, colchicine) and time needed for discontinuation; (3) number of relapses during continuous anakinra treatment; and (4) number of relapses during anakinra tapering or discontinuation. RESULTS: All patients treated had a complete response within a few days and were able to rapidly withdraw concomitant treatments, including corticosteroids. During daily treatment, no patient had a relapse of the disease; 14 patients started tapering and 6 of them experienced a relapse, with a prompt response after anakinra reintroduction. Overall, after a median follow-up of 39 months (range 6-57), a 95% reduction of flares was observed compared with pretreatment period. CONCLUSION: The long-term use of anakinra in monotherapy is associated with persistent control of recurrent pericarditis.
OBJECTIVE: To evaluate the long-term response and safety of interleukin-1 receptor antagonist (anakinra) in recurrent pericarditis. STUDY DESIGN: Fifteen patients (12 children, 3 adults) were enrolled in a multicenter retrospective study. All the patients were corticosteroid-dependent and 14 had received colchicine. Anakinra was given at 1-2 mg/kg/d. The primary outcome of the study was a reduction of at least 70% of disease flares after anakinra treatment compared with the pretreatment period. Secondary outcomes were: (1) number of complete or partial responders to anakinra and time for complete response; (2) number of patients who discontinued other ongoing treatments (non-steroidal anti-inflammatory drugs, corticosteroid, colchicine) and time needed for discontinuation; (3) number of relapses during continuous anakinra treatment; and (4) number of relapses during anakinra tapering or discontinuation. RESULTS: All patients treated had a complete response within a few days and were able to rapidly withdraw concomitant treatments, including corticosteroids. During daily treatment, no patient had a relapse of the disease; 14 patients started tapering and 6 of them experienced a relapse, with a prompt response after anakinra reintroduction. Overall, after a median follow-up of 39 months (range 6-57), a 95% reduction of flares was observed compared with pretreatment period. CONCLUSION: The long-term use of anakinra in monotherapy is associated with persistent control of recurrent pericarditis.
Authors: Stephanie R Harrison; Dennis McGonagle; Sharmin Nizam; Stephen Jarrett; Jeroen van der Hilst; Michael F McDermott; Sinisa Savic Journal: JCI Insight Date: 2016-05-05
Authors: Antonio Brucato; Giacomo Emmi; Luca Cantarini; Andrea Di Lenarda; Marco Gattorno; Giuseppe Lopalco; Renzo Marcolongo; Massimo Imazio; Alberto Martini; Domenico Prisco Journal: Intern Emerg Med Date: 2018-04-09 Impact factor: 3.397