Department of Medicine, Albany Medical College, USA.
Albany Medical College, USA.
Eur Heart J Acute Cardiovasc Care. 2020 Dec;9(8):888-892. doi: 10.1177/2048872619886309. Epub 2020 Mar 11.
Anakinra, a recombinant interleukin-1 receptor antagonist is effective in treatment of idiopathic recurrent pericarditis. However, its efficacy in non-idiopathic pericarditis (secondary to a diagnosed inflammatory condition, or other known etiology) is unclear. We evaluated the efficacy of anakinra in patients with non-idiopathic (secondary to a diagnosed inflammatory condition, or other known etiology) and idiopathic pericarditis, who were intolerant or refractory to conventional therapy (colchicine and corticosteroids).
This was a single-center study in which we performed a retrospective chart review of consecutive adult patients hospitalized with pericarditis intolerant or refractory to conventional therapy who were treated with conventional therapy and anakinra between January 2016-October 2018. The control group included age-matched hospitalized pericarditis patients treated with conventional therapy only. Symptom relief at discharge, time to symptom relief and recurrence on treatment were compared. The effect of outpatient continuation of anakinra on post-treatment recurrence risk was assessed.
Twelve patients received anakinra for pericarditis; 22 age-matched controls were identified. Ten patients (83.3%) in the conventional therapy and anakinra group and 13 patients (54.1%) in the conventional therapy groups had non-idiopathic pericarditis. All conventional therapy and anakinra patients and 16 of 22 patients in the conventional therapy group reported symptom relief at discharge (=0.04). Time to symptom relief was decreased in the conventional therapy and anakinra group (3.75±1.87 vs 5.63±3.28 days, =0.08). During treatment, all conventional therapy and anakinra-treated patients continued to be symptom free, while nine of 22 conventional therapy patients (40.9%) experienced recurrence (=0.009). Recurrence risk after treatment discontinuation was similar in the conventional therapy and anakinra group and the conventional therapy group.
In hospitalized patients with non-idiopathic or idiopathic pericarditis refractory, or intolerant to, conventional therapy, anakinra is associated with improved symptom relief and decreased recurrence risk during treatment.
阿那白滞素是一种重组白细胞介素-1 受体拮抗剂，在治疗特发性复发性心包炎方面有效。然而，其在非特发性心包炎（继发于已诊断的炎症性疾病或其他已知病因）中的疗效尚不清楚。我们评估了阿那白滞素在对常规治疗（秋水仙碱和皮质类固醇）不耐受或无效的非特发性（继发于已诊断的炎症性疾病或其他已知病因）和特发性心包炎患者中的疗效。
这是一项单中心研究，我们对 2016 年 1 月至 2018 年 10 月期间因常规治疗不耐受或无效而住院的特发性和非特发性心包炎成年患者进行了回顾性病历审查，这些患者接受了常规治疗和阿那白滞素治疗。对照组包括仅接受常规治疗的年龄匹配的住院心包炎患者。比较出院时症状缓解情况、症状缓解时间和治疗后复发情况。评估门诊继续使用阿那白滞素对治疗后复发风险的影响。
12 例患者因心包炎接受阿那白滞素治疗；确定了 22 例年龄匹配的对照组。常规治疗和阿那白滞素组 10 例（83.3%）和常规治疗组 13 例（54.1%）患者患有非特发性心包炎。常规治疗和阿那白滞素组和常规治疗组的所有患者中有 16 例报告出院时症状缓解（=0.04）。常规治疗和阿那白滞素组的症状缓解时间缩短（3.75±1.87 与 5.63±3.28 天，=0.08）。在治疗期间，所有接受常规治疗和阿那白滞素治疗的患者均无症状，而常规治疗组的 9 例患者（40.9%）出现复发（=0.009）。治疗停药后，常规治疗和阿那白滞素组与常规治疗组的复发风险相似。
在常规治疗不耐受或无效的住院非特发性或特发性心包炎患者中，阿那白滞素可改善症状缓解，并降低治疗期间的复发风险。
