title: Long-term efficacy of interleukin-1 receptor antagonist (anakinra) in corticosteroid-dependent and colchicine-resistant recurrent pericarditis.
abstract: OBJECTIVE
  To evaluate the long-term response and safety of interleukin-1 receptor antagonist (anakinra) in recurrent pericarditis.
  
  
  METHODS
  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.
  
  
  CONCLUSIONS
  The long-term use of anakinra in monotherapy is associated with persistent control of recurrent pericarditis.
authors.affiliation: UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Martina
authors.initials: M
authors.lastname: Finetti
authors.affiliation: Ospedale Pediatrico Bambino Gesù, Rome, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Insalaco
authors.affiliation: Policlinico Le Scotte, Università di Siena, Siena, Italy.
authors.forename: Luca
authors.initials: L
authors.lastname: Cantarini
authors.affiliation: Spedali Civili di Brescia, Brescia, Italy.
authors.forename: Antonella
authors.initials: A
authors.lastname: Meini
authors.affiliation: Ospedale Policlinico Chieti, Chieti, Italy.
authors.forename: Luciana
authors.initials: L
authors.lastname: Breda
authors.affiliation: Università Federico II, Napoli, Italy.
authors.forename: Maria
authors.initials: M
authors.lastname: Alessio
authors.affiliation: UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Matteo
authors.initials: M
authors.lastname: D'Alessandro
authors.affiliation: UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy.
authors.forename: Paolo
authors.initials: P
authors.lastname: Picco
authors.affiliation: UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy; Università di Genoa, Genoa, Italy.
authors.forename: Alberto
authors.initials: A
authors.lastname: Martini
authors.affiliation: UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy. Electronic address: marcogattorno@ospedale-gaslini.ge.it.
authors.forename: Marco
authors.initials: M
authors.lastname: Gattorno
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones / Q000009:adverse effects / Q000627:therapeutic use*; D002648:Child; D015331:Cohort Studies; D003078:Colchicine / Q000009:adverse effects / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D004351:Drug Resistance; D005260:Female; D005500:Follow-Up Studies; D006801:Humans; D053590:Interleukin 1 Receptor Antagonist Protein / Q000008:administration & dosage*; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000175:diagnosis / Q000188:drug therapy*; D012008:Recurrence; D012189:Retrospective Studies; D012720:Severity of Illness Index; D013997:Time Factors; D016896:Treatment Outcome; D055815:Young Adult
chemical_list: D000305:Adrenal Cortex Hormones; D053590:Interleukin 1 Receptor Antagonist Protein; D003078:Colchicine