Anakinra in idiopathic recurrent pericarditis: a comprehensive case series and literature review Anakinra bei idiopathischer rezidivierender Perikarditis: umfangreiche Fallserie und Literaturübersicht


Toker Dincer Z., Karup S., YILMAZ B. E., Corbali O., Azman F. N., MELİKOĞLU M., ...Daha Fazla

Zeitschrift fur Rheumatologie, cilt.83, sa.7, ss.587-596, 2024 (SCI-Expanded, Scopus) identifier identifier identifier

  • Yayın Türü: Makale / Tam Makale
  • Cilt numarası: 83 Sayı: 7
  • Basım Tarihi: 2024
  • Doi Numarası: 10.1007/s00393-023-01471-x
  • Dergi Adı: Zeitschrift fur Rheumatologie
  • Derginin Tarandığı İndeksler: Science Citation Index Expanded (SCI-EXPANDED), Scopus, BIOSIS, CAB Abstracts
  • Sayfa Sayıları: ss.587-596
  • Anahtar Kelimeler: Autoinflammatory disease, Colchicine, IL-1 inhibitor, Pericarditis management, Steroid tapering
  • İstanbul Üniversitesi-Cerrahpaşa Adresli: Evet

Özet

Objective: Idiopathic recurrent pericarditis (IRP) is defined by recurring episodes of pericardial inflammation without a known cause. This study investigates the safety and efficacy of anakinra, an interleukin‑1 inhibitor, as a successful therapy for IRP in cases resistant to conventional treatment. Methods: A retrospective evaluation of patients treated at our autoinflammatory center between 2011 and 2023 was conducted. Patient files were examined for demographic, clinical, and treatment response data, including nonsteroid anti-inflammatory drugs (NSAIDs), corticosteroids, and colchicine. Monogenic autoinflammatory disease screening was performed for Mediterranean Fever (MEFV), tumor necrosis factor receptor-associated periodic syndrome (TRAPS), mevalonate kinase (MVK), nucleotide-binding domain, leucine-rich–containing family, pyrin domain–containing-3 (NLRP3), and nucleotide-binding oligomerization domain-containing protein 2 (NOD2). Patients who experienced multiple episodes of pericarditis were diagnosed with recurrent pericarditis. The study evaluated anakinra treatment in IRP patients unresponsive to conventional therapy. Results: The study included 21 participants, 9 (42.9%) female and 12 (57.1%) male. The average age of the participants was 43.1 ± 16.5 years. The MEFV mutation analysis revealed that 2 (9.5%) had a mutation in exon 10 and 4 (19.0%) had one in exon 2. Out of the 16 cases, 15 successfully discontinued steroid treatment. Four patients (19.0%) experienced injection site reactions. C‑reactive protein (CRP) levels were measured at an average of 196 ± 67.8 mg/l before and 2.6 ± 3.15 mg/l after anakinra treatment. Conclusion: In conclusion, the study adds to the growing evidence for the efficacy of interleukin-1 inhibitors, such as anakinra, as a promising treatment modality for IRP in cases resistant to conventional treatment.