Interleukin-1 inhibitors for pericarditis

Pathophysiology of pericarditis involves complex interaction of environmental factors, genetic predisposition and activation of innate and acquired immunity. Pericarditis can be treated with NSAIDs, colchicin, glucocorticoids and immunosuppressive agents. Interleuikin (IL)-1 inhibitors, including anakinra, rilonacept and canakinumab, have been proposed as a new treatment for recurrent pericarditis. Anakinra is a recombinant, non-glycosylated form of IL-1Ra that inhibits IL-1 by binding to the IL-1 receptor. Available evidence suggest that anakinra and rilonacept can be effectively used in patients with idiopathic recurrent pericarditis that is resistant to standard therapy. Efficacy of anakinra, particularly at earlier stages of pericarditis, may identify autoinflammatory phenotype of recurrent pericarditis and will contribute to implementation of personalised treatment for this disease.

Key words

Idiopathic recurrent pericarditis, immunemediated inflammatory rheumatic diseases, IL-1, anakinra, rilonacept, canakinumab.