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Anakinra for the management of resistant idiopathic recurrent pericarditis. Initial experience in 10 adult cases
  1. George Lazaros1,
  2. Panagiotis Vasileiou1,
  3. Christos Koutsianas2,
  4. Katerina Antonatou2,
  5. Christodoulos Stefanadis1,
  6. Dimitrios Pectasides2,
  7. Dimitrios Vassilopoulos2
  1. 1 1st Department of Cardiology, University of Athens Medical School, Hippokration General Hospital, Athens, Greece
  2. 2 2nd Department of Medicine and Laboratory, Clinical Immunology and Rheumatology Unit, University of Athens Medical School, Hippokration General Hospital, Athens, Greece
  1. Correspondence to
    Dr Dimitrios Vassilopoulos, Clinical Immunology and Rheumatology Unit, 2nd Department of Medicine and Laboratory, Hippokration General Hospital, University of Athens School of Medicine, 114 Vass. Sophias Ave., Athens 115 27, Greece; dvassilop{at}med.uoa.gr

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Recurrent idiopathic pericarditis is a common, problematic complication of acute pericarditis, occurring in approximately 30% of cases.1 Despite appropriate management with non-steroidal anti-inflammatory drugs (NSAIDs), colchicine and corticosteroids (CS), a number of patients are either resistant to treatment requiring long-term therapy with high doses of CS or intolerant to therapy.2–4

This disease is currently viewed as an autoinflammatory disease based on its clinical and laboratory features (recurrent episodes of sterile serosal inflammation in the absence of specific autoreactive antibodies or T cells),5–7 and the preliminary results showing favourable response to intereleukin-1 (IL-1) inhibition.8–10 Anakinra, a known IL-1 receptor antagonist, has been successfully used in small series of paediatric patients8 ,9 while we have recently first reported its efficacy and safety in three adult patients.10 In this report, we extend our follow-up on these three patients, and present data on seven more adult patients treated with anakinra. …

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