@article{3104437,
    title = "Anakinra for corticosteroid-dependent and colchicine-resistant pericarditis: The IRAP (International Registry of Anakinra for Pericarditis) study",
    author = "Imazio, M. and Andreis, A. and De Ferrari, G.M. and Cremer, P.C. and Mardigyan, V. and Maestroni, S. and Luis, S.A. and Lopalco, G. and Emmi, G. and Lotan, D. and Marcolongo, R. and Lazaros, G. and De Biasio, M. and Cantarini, L. and Dagna, L. and Cercek, A.C. and Pivetta, E. and Varma, B. and Berkson, L. and Tombetti, E. and Iannone, F. and Prisco, D. and Caforio, A.L.P. and Vassilopoulos, D. and Tousoulis, D. and De Luca, G. and Giustetto, C. and Rinaldi, M. and Oh, J.K. and Klein, A.L. and Brucato, A. and Adler, Y.",
    journal = "European Journal of Preventive Cardiology",
    year = "2020",
    volume = "27",
    number = "9",
    pages = "956-964",
    publisher = "SAGE Publications Inc.",
    issn = "2047-4873, 2047-4881",
    doi = "10.1177/2047487319879534",
    keywords = "anakinra;  C reactive protein;  colchicine;  corticosteroid;  interleukin 1 receptor blocking agent;  colchicine;  corticosteroid;  immunologic factor;  interleukin 1 receptor blocking agent, adult;  aged;  arthralgia;  Article;  atrial fibrillation;  clinical outcome;  diverticulitis;  drug efficacy;  drug safety;  drug substitution;  drug withdrawal;  Escherichia coli;  female;  fever;  follow up;  hospitalization;  hot flush;  human;  hypereosinophilia;  hypertransaminasemia;  inflammation;  major clinical study;  male;  middle aged;  multicenter study;  myalgia;  neutropenia;  neutrophil count;  optic neuritis;  pericardial effusion;  pericardiectomy;  pericarditis;  priority journal;  prospective study;  recurrent disease;  skin abscess;  skin manifestation;  very elderly;  adolescent;  clinical trial;  diagnostic imaging;  drug administration;  drug resistance;  pericarditis;  recurrent disease;  register;  time factor;  treatment outcome;  young adult, Adolescent;  Adrenal Cortex Hormones;  Adult;  Aged;  Aged, 80 and over;  Colchicine;  Drug Administration Schedule;  Drug Resistance;  Drug Tapering;  Female;  Humans;  Immunologic Factors;  Interleukin 1 Receptor Antagonist Protein;  Male;  Middle Aged;  Pericarditis;  Recurrence;  Registries;  Time Factors;  Treatment Outcome;  Young Adult",
    abstract = "Aims: Novel therapies are needed for recurrent pericarditis, particularly when corticosteroid dependent and colchicine resistant. Based on limited data, interleukin-1 blockade with anakinra may be beneficial. The aim of this multicentre registry was to evaluate the broader effectiveness and safety of anakinra in a ‘real world’ population. Methods and results: This registry enrolled consecutive patients with recurrent pericarditis who were corticosteroid dependent and colchicine resistant and treated with anakinra. The primary outcome was the pericarditis recurrence rate after treatment. Secondary outcomes included emergency department visits, hospitalisations, corticosteroid use and adverse events. Among 224 patients (46 ± 14 years old, 63% women, 75% idiopathic), the median duration of disease was 17 months (interquartile range 9–33). Most patients had elevated C-reactive protein (91%) and pericardial effusion (88%). After a median treatment of 6 months (3–12), pericarditis recurrences were reduced six-fold (2.33–0.39 per patient per year), emergency department admissions were reduced 11-fold (1.08–0.10 per patient per year), hospitalisations were reduced seven-fold (0.99–0.13 per patient per year). Corticosteroid use was decreased by anakinra (respectively from 80% to 27%; P < 0.001). No serious adverse events occurred; adverse events consisted mostly of transient skin reactions (38%) at the injection site. Adverse events led to discontinuation in 3%. A full-dose treatment duration of over 3 months followed by a tapering period of over 3 months were the therapeutic schemes associated with a lower risk of recurrence. Conclusion: In patients with recurrent pericarditis, anakinra appears efficacious and safe in reducing recurrences, emergency department admissions and hospitalisations. © The European Society of Cardiology 2019."
}