Τίτλος:
Anakinra: an emerging option for refractory idiopathic recurrent
pericarditis: a systematic review of published evidence
Γλώσσες Τεκμηρίου:
Αγγλικά
Περίληψη:
AimsAccumulating evidence suggests idiopathic recurrent pericarditis as
a disease of probable autoinflammatory origin, and thus anakinra could
be of benefit. The goal of this systematic review was to assess the
efficacy and safety of anakinra in this context.MethodsReports relevant
to anakinra administration in patients with idiopathic recurrent
pericarditis published up to October 2014 were searched in several
databases. All references found, upon initial assessment at title and
abstract level for suitability, were consequently retrieved as full
reports for further appraisal.ResultsAmong 12 citations retrieved, nine
reports (four case series and five case reports with 34 patients, 20
men, mean age 26.8 years) were assessed. The mean disease duration was
31 months and the number of recurrences 8.2. Anakinra was generally
administered as a daily subcutaneous injection of 100mg or as a mean
dose of 1.1mg/kg/d in weight-adjusted regimens. The mean full-dose
duration was 9.2 months. C-reactive protein normalized within 7.1 days,
and steroids were withdrawn within 62 days. Dose tapering was adopted in
64.7% of patients, leading to recurrence in 26% of cases. In a
28.3-month follow-up, eight out of 34 patients (23.5%) were disease
free without treatment, after having received anakinra for 10.4months
overall. Anakinra was proved well tolerated, with mild local reaction
being reported in 44% of patients.ConclusionAnakinra is a highly
effective, rapidly acting, well tolerated and steroid-sparing agent.
Recurrences after drug discontinuation are a matter of concern.
Randomized trials are required to confirm these findings and address the
most effective treatment protocol.
Συγγραφείς:
Lazaros, George
Imazio, Massimo
Brucato, Antonio and
Vassilopoulos, Dimitrios
Vasileiou, Panagiotis
Gattorno, Marco
and Tousoulis, Dimitrios
Martini, Alberto
Περιοδικό:
Journal of cardiovascular medicine (Hagerstown, Md.)
Εκδότης:
Lippincott, Williams & Wilkins
Λέξεις-κλειδιά:
anakinra; autoinflammatory diseases; efficacy; idiopathic; recurrent
pericarditis; safety
DOI:
10.2459/JCM.0000000000000266
