Journal
EUROPEAN HEART JOURNAL-CARDIOVASCULAR PHARMACOTHERAPY
Volume 4, Issue 1, Pages 46-53Publisher
OXFORD UNIV PRESS
DOI: 10.1093/ehjcvp/pvx018
Keywords
Pericarditis; Anakinra; Interleukin-1; Human interleukin-1 receptor antagonist
Funding
- Swedish Orphan Biovitrum (Stockholm, Sweden) - National Heart, Lung, and Blood Institute (National Institutes of Health, USA) [NCT02173548, NCT01950299, NCT01936909]
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Pericarditis is a debilitating condition that results from profound inflammation of the pericardial tissue. Between 10 and 15% of first episodes of acute pericarditis will be followed by several episodes refractory to conventional treatment. Current standard of care for pericarditis treatment includes high-dose non-steroidal anti-inflammatory drugs, colchicine, and systemic corticosteroids, each associated with potentially severe toxicities and nominal efficacy. Interleukin-1 (IL-1), an apical pro-inflammatory cytokine, plays an important role as an autocrine magnifier of systemic inflammation in pericarditis. Interruption of the IL-1 circuit has been shown to have a favourable risk profile in several disease states. In this review, we discuss the growing body of evidence which supports the use of IL-1 blockade in the treatment of recurrent pericarditis as well as provide practical considerations for the use of IL-1 blockade in clinical practice.
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