Long-term efficacy of interleukin-1 receptor antagonist (Anakinra) in corticosteroid-dependent and colchicine-resistant recurrent pericarditis

Martina Finetti, Antonella Insalaco, Luca Cantarini, Antonella Meini, Luciana Breda, Maria Alessio, Matteo D'Alessandro, Paolo Picco, Alberto Martini, Marco Gattorno

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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.

Original languageEnglish
JournalJournal of Pediatrics
Volume164
Issue number6
DOIs
Publication statusPublished - 2014

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Interleukin 1 Receptor Antagonist Protein
Pericarditis
Interleukin-1 Receptors
Colchicine
Adrenal Cortex Hormones
Recurrence
Therapeutics
Multicenter Studies
Anti-Inflammatory Agents
Retrospective Studies
Outcome Assessment (Health Care)
Safety

ASJC Scopus subject areas

  • Pediatrics, Perinatology, and Child Health

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Long-term efficacy of interleukin-1 receptor antagonist (Anakinra) in corticosteroid-dependent and colchicine-resistant recurrent pericarditis. / Finetti, Martina; Insalaco, Antonella; Cantarini, Luca; Meini, Antonella; Breda, Luciana; Alessio, Maria; D'Alessandro, Matteo; Picco, Paolo; Martini, Alberto; Gattorno, Marco.

In: Journal of Pediatrics, Vol. 164, No. 6, 2014.

Research output: Contribution to journalArticle

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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.",
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AU - Finetti, Martina

AU - Insalaco, Antonella

AU - Cantarini, Luca

AU - Meini, Antonella

AU - Breda, Luciana

AU - Alessio, Maria

AU - D'Alessandro, Matteo

AU - Picco, Paolo

AU - Martini, Alberto

AU - Gattorno, Marco

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N2 - 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.

AB - 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.

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