• Martina Finetti, Antonella Insalaco, Luca Cantarini, Antonella Meini, Luciana Breda, Maria Alessio, Matteo D'Alessandro, Paolo Picco, Alberto Martini, and Marco Gattorno.
• UO Pediatria II, Istituto Giannina Gaslini, Genoa, Italy.
• J. Pediatr. 2014 Jun 1; 164 (6): 1425-31.e1.

ObjectiveTo evaluate the long-term response and safety of interleukin-1 receptor antagonist (anakinra) in recurrent pericarditis.Study DesignFifteen patients (12 children, 3 adults) were enrolled in a multicenter retrospective study. All the patients were corticosteroid-dependent and 14 had received colchicine. Anakinra was given at 1-2 mg/kg/d. The primary outcome of the study was a reduction of at least 70% of disease flares after anakinra treatment compared with the pretreatment period. Secondary outcomes were: (1) number of complete or partial responders to anakinra and time for complete response; (2) number of patients who discontinued other ongoing treatments (non-steroidal anti-inflammatory drugs, corticosteroid, colchicine) and time needed for discontinuation; (3) number of relapses during continuous anakinra treatment; and (4) number of relapses during anakinra tapering or discontinuation.ResultsAll patients treated had a complete response within a few days and were able to rapidly withdraw concomitant treatments, including corticosteroids. During daily treatment, no patient had a relapse of the disease; 14 patients started tapering and 6 of them experienced a relapse, with a prompt response after anakinra reintroduction. Overall, after a median follow-up of 39 months (range 6-57), a 95% reduction of flares was observed compared with pretreatment period.ConclusionThe long-term use of anakinra in monotherapy is associated with persistent control of recurrent pericarditis.Copyright © 2014 Elsevier Inc. All rights reserved.

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