Interleukin-1 Blockers for the Treatment of Recurrent Pericarditis: Pathophysiology, Patient-Reported Outcomes, and Perspectives.

IF 2.6 4区医学 Q2 CARDIAC & CARDIOVASCULAR SYSTEMS Journal of Cardiovascular Pharmacology Pub Date : 2024-06-01 DOI:10.1097/FJC.0000000000001435

Georgia K Thomas, Aldo Bonaventura, Alessandra Vecchié, Benjamin van Tassell, Massimo Imazio, Allan Klein, Sushil Allen Luis, Antonio Abbate

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Abstract

Abstract: Recurrent pericarditis (RP) is the most troublesome complication of acute pericarditis reflecting an unresolving inflammation of the pericardial sac around the heart and associated with significant morbidity. Recent studies have shown interleukin-1 (IL-1) signaling to be central to the pathophysiology of cases of RP with evidence of activation of systemic inflammation. We herein review the literature and clinical trials discussing the utility of IL-1 blockade for RP. The early experience of IL-1 blockade with anakinra (Kineret) and its favorable safety profile paved the way for the clinical development of rilonacept (Arcalyst) and subsequent approval by the US FDA for RP. In patients with RP who have become colchicine-resistant and glucocorticoid-dependent, IL-1 blockade with rilonacept or anakinra effectively treats recurrences and prevents future flares and significantly improves quality of life.

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治疗复发性心包炎的白介素-1 阻滞剂：病理生理学、患者报告结果和前景。

摘要：复发性心包炎（RP）是急性心包炎最棘手的并发症，反映了心脏周围心包囊的炎症尚未消退，与严重的发病率有关。最近的研究表明，白细胞介素-1（IL-1）信号转导是 RP 病例病理生理学的核心，有证据表明它激活了全身炎症。我们在此回顾了有关 IL-1 阻断治疗 RP 的文献和临床试验。使用 Anakinra（Kineret）阻断 IL-1 的早期经验及其良好的安全性为 rilonacept（Arcalyst）的临床开发铺平了道路，随后 RP 获得了美国 FDA 的批准。对于对秋水仙碱耐药和依赖糖皮质激素的 RP 患者，使用利龙赛普或 Anakinra 阻断 IL-1 可有效治疗复发和预防未来复发，并显著改善生活质量。

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来源期刊

Journal of Cardiovascular Pharmacology 医学-心血管系统

CiteScore

5.10

自引率

3.30%

发文量

367

审稿时长

1 months

期刊介绍： Journal of Cardiovascular Pharmacology is a peer reviewed, multidisciplinary journal that publishes original articles and pertinent review articles on basic and clinical aspects of cardiovascular pharmacology. The Journal encourages submission in all aspects of cardiovascular pharmacology/medicine including, but not limited to: stroke, kidney disease, lipid disorders, diabetes, systemic and pulmonary hypertension, cancer angiogenesis, neural and hormonal control of the circulation, sepsis, neurodegenerative diseases with a vascular component, cardiac and vascular remodeling, heart failure, angina, anticoagulants/antiplatelet agents, drugs/agents that affect vascular smooth muscle, and arrhythmias. Appropriate subjects include new drug development and evaluation, physiological and pharmacological bases of drug action, metabolism, drug interactions and side effects, application of drugs to gain novel insights into physiology or pathological conditions, clinical results with new and established agents, and novel methods. The focus is on pharmacology in its broadest applications, incorporating not only traditional approaches, but new approaches to the development of pharmacological agents and the prevention and treatment of cardiovascular diseases. Please note that JCVP does not publish work based on biological extracts of mixed and uncertain chemical composition or unknown concentration.