Recurrent pericarditis: can anakinra offer a promising therapy in adults with refractory symptoms?

摘要: We read with great pleasure the work by Imazio, which is, as usual, another of his excellent contributions to pericardial disease research. Imazio discussed treatment recurrent pericarditis and emphasized importance colchicine in addition standard modalities. This is backed up randomized controlled evidence from CORP-1 CORP-2 trials, constitute pioneer on this subject. One aspect remains frustrating for both clinicians patients: multiple recurrences leading refractory pericarditis. According recent data trial, at least 22% patients experienced a recurrence despite receiving 6 months therapy Such often experience debilitating symptoms may progress develop A polypharmacy approach utilized such patients, includes combination NSAIDs, colchicine, steroids. Despite use, large subgroup these symptoms. Anecdotal clinical utilizing interleukin-1 inhibitors has proven beneficial Anakinra (an inhibitor) was recently used small prospective investigation, mostly involving pediatric population. The results showed that anakinra could be potential modality not been significantly United States indication. Since an Italian study, we wonder if et al have their adult Therapeutic surgical modalities like pericardiectomy are last resort management It option constrictive physiology, tamponade, or unacceptable complications respect medical therapy; however, pericardiectomy, relapse chest pain In contrast, percutaneous balloon pericardiotomy minimally invasive procedure can effectively neoplastic effusions earlier course. offers palliative benefit improves quality life due malignant effusions.