The Use of IL-1 Receptor Antagonist (Anakinra) in Idiopathic Recurrent Pericarditis: A Narrative Review

Table 1

Studies on the efficacy of anakinra in idiopathic recurrent pericarditis.

Study	Number of patients	Age (years)	Anakinra dose	Follow-up	Adverse reaction	Note
Picco et al., 2009 [21]	3	12, 13, 14	1–1.25 mg/kg/day	6 months	None reported	Pericarditis recurred in all 3 patients when anakinra was stopped but resolved on reinitiation of anakinra
Vassilopoulos et al., 2012 [19]	3	26, 36, 19	100–150 mg	6–15 months	Transient transaminase elevation in 1 patient	(i) Anakinra discontinued without recurrence in 1 patient after 6 weeks; (ii) One recurrence after discontinuation of anakinra, which was treated with colchicine and ibuprofen; (iii) One recurrence after anakinra discontinuation treated with anakinra reinstitution
Lazaros et al., 2014 [36]	10	Median: 39 (24–60 years)	100 mg daily for 6 months followed by 100 mg on alternate days for 6 months	8–40 months	Minor skin reactions (6/10)	(i) Date from 3 patients from [16] were included; (ii) In the remaining 7 patients, 5/7 had recurrence after stopping anakinra. Anakinra was reinitiated in 4 and recurrence was treated conservatively in 1
Finetti et al., 2014 [17]	15	Median: 16 (8–60 years)	1-2 mg/kg/day	39 months (6–57 months)	Minor skin reactions	At follow-up, 10 were on anakinra monotherapy and 3 were weaned off all medications
Jain et al., 2015 [37]	13	Median: 49 (33–73 years)	100 mg daily	16.8 months (1.3–24 months)	Transient local reaction in 4 patients	(i) Anakinra weaned without recurrence in 2 patients; (ii) Eleven patients remained on anakinra at follow-up
Brucato et al., 2015, RCT [20]	21	Mean: 45.4 years	100 mg daily (adult); 2 mg/kg/day (child)	2 months, all patients; 6 months, RCT	Transient local reaction (); Herpes zoster (); Optic neuropathy ()	(i) None of the patients on the anakinra group had recurrences; (ii) All patients on placebo developed recurrent pericarditis

RCT: randomized controlled trial.