Journal of the American Heart Association
October 16, 2026 · via Europe PMC
Early Introduction and Prolonged Full-Dose Anakinra Reduce Recurrence Risk After Discontinuation in Recurrent Pericarditis: An International Multicenter Cohort.
Malandrino D, Bettiol A, Andreis A, +24 more, Emmi G
AI summary — for doctors, generated from the abstract only
In refractory recurrent pericarditis, starting anakinra early and keeping full-dose treatment for at least 6 months were each linked to fewer relapses after stopping.
What was studied
Retrospective multicenter cohort of 185 adults with corticosteroid-dependent, colchicine-resistant recurrent pericarditis from 16 international centers who permanently discontinued anakinra after remission, using Cox regression for predictors of relapse.
Key findings
- 68 patients (36.8%) had a recurrence after discontinuation, with a median time to recurrence of 2.1 months.
- Starting within 12 months of the first episode was independently associated with lower recurrence risk (HR 0.33, 95% CI 0.18-0.66).
- Maintaining full-dose therapy for 6 months or longer was also associated with lower recurrence risk (HR 0.48, 95% CI 0.23-0.86).
Clinical relevance
The findings may inform how long anakinra is continued before attempting discontinuation, supporting earlier initiation in patients who need it.
Who should care
Limitations
Retrospective and nonrandomized, with a short median follow-up of 7.2 months after discontinuation, so later relapses may be missed. Only patients who stopped therapy after remission were included, which introduces selection bias.
Earlier and longer full-dose anakinra was associated with fewer relapses after discontinuation, but this needs prospective confirmation.
This is an AI-generated summary of the published abstract, not a clinical recommendation. It may not reflect the full text or subsequent updates — verify against the original source before acting on it.
Abstract
BACKGROUND
Anakinra is effective in recurrent pericarditis, yet optimal treatment duration and strategies for safe drug discontinuation remain uncertain. Identifying predictors of sustained remission after discontinuation is important for clinical management.
METHODS
We retrospectively analyzed 185 consecutive adult patients with corticosteroid-dependent and colchicine-resistant refractory recurrent pericarditis across 16 international referral centers, who permanently discontinued therapy after clinical remission. The primary end point was pericarditis recurrence after drug discontinuation. Univariate and multivariable Cox proportional hazards regression and Kaplan-Meier analyses were performed to identify demographic, clinical, and therapeutic predictors of postdiscontinuation relapse.
RESULTS
Among 185 patients who discontinued anakinra (58.4% women, mean age 50.4±17.8 years, 77% idiopathic cause), treatment was initiated a median of 10 months (interquartile range [IQR], 4.0-19.5) after the first episode and continued at 100 mg/d for a median of 6 months (IQR, 4-12). Over a median follow-up of 7.2 months (IQR, 1.5-23.3) after discontinuation, 68 patients (36.8%) experienced recurrence, with a median time to recurrence of 2.1 months (IQR, 0.7-8.5). Initiation within 12 months from the first pericarditis episode and maintenance of full-dose therapy (100 mg/d) for ≥6 months were independently associated with lower recurrence risk (hazard ratio [HR], 0.33 [95% CI, 0.18-0.66];=0.001 and HR, 0.48 [95% CI, 0.23-0.86];=0.017; respectively).
CONCLUSIONS
Early initiation of anakinra and maintenance of full-dose therapy for at least 6 months are associated with a significantly lower risk of relapse after discontinuation and may inform treatment duration and discontinuation strategies in recurrent pericarditis.
DOI
10.1161/JAHA.126.050181
PMID
42885757
Research metadata (titles, abstracts, authors, publication dates) is sourced from Europe PMC, which aggregates content from PubMed/MEDLINE, PubMed Central, and other providers under the U.S. National Library of Medicine (NLM/NCBI). NLM does not claim copyright on abstracts; the original journal publishers or authors may hold rights to the full articles. AI-generated summaries are derived only from the abstract, never the full text, and are always labeled as AI-generated.
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