Treatment Can Reduce Pericarditis in RA

Taking anakinra, a drug that treats rheumatoid arthritis, can significantly reduce pericarditis in patients with highly inflammatory disease and elevated CRP protein, according to a small study.

Among acute pericarditis instances, recurrence occurs in 30 percent of cases. Most patients with recurrent cases don’t respond to or can’t tolerate NSAID, corticosteroid or colchicine treatments. But, for those with a history of high fever, elevated CRP level and pleural effusions, anakinra can be highly effective.

In a presentation given on Nov. 10 at the 2015 ACR/ARHP annual meeting in San Francisco, Calif., Antonio Brucato, MD, an internal medicine specialist with Hospital Papa Giovanni XXIII in Bergamo Italy, discussed the role anakinra plays in controlling the interleukin-1 family cytokines responsible for regulating immune responses and inflammation, particularly in patients with high-disease activity.

“We were impressed to see how quick and immediate the effect of anakinra was on patients with severe, acute and inflammatory disease,” he said. “It allowed for the prompt discontinuation of other drugs.”

Anakinra showed itself to be effective and safe, he said, with the most common side effect being a mild injection-site skin reaction.

In the double-blind study conducted in three medical centers, 21 patients were divided into two groups – a placebo group and an anakinra-treatment group. Between June 2014 and June 2015, pericarditis recurrence occurred in nine out of 10 participants in the placebo group and in two of 11 anakinra-treatment participants. The median time to a flare-up among the placebo group was just over 48 days.

After a patient achieves remission, Brucato said, they should complete a gradual anakinra taper, reducing the dose by 100 mg/week until they drop to 300 mg/week. They should, then, reduce by another 100 mg/week every two-to-three months.

Disclosures:

The study was funded by SOBI, a Sweden-based integrated biopharmaceutical company dedicated to innovative therapies and services that target rare diseases.

References:

“Anakinra in Patients with Cortico-Dependent Idiopathic Recurrent Pericarditis: A Randomized Double-Blind Placebo-Controlled Withdrawal Trial;” Antonio Brucato, M.D.; Nov. 10, 2015; 11 a.m. – 12:30 p.m., ACR 2015.