| Autor: |
Lo Presti S; Center for the Diagnosis and Treatment of Pericardial Diseases Section of Cardiovascular Imaging Department of Cardiovascular Medicine Heart, Vascular, and Thoracic InstituteCleveland Clinic Cleveland OH., Elajami TK; Columbia University Division of CardiologyMount Sinai Heart Institute Miami Beach FL., Reyaldeen R; Center for the Diagnosis and Treatment of Pericardial Diseases Section of Cardiovascular Imaging Department of Cardiovascular Medicine Heart, Vascular, and Thoracic InstituteCleveland Clinic Cleveland OH., Anthony C; Center for the Diagnosis and Treatment of Pericardial Diseases Section of Cardiovascular Imaging Department of Cardiovascular Medicine Heart, Vascular, and Thoracic InstituteCleveland Clinic Cleveland OH., Imazio M; University CardiologyA.O.U. Città della Salute e della Scienza di Torino Turin Italy., Klein AL; Center for the Diagnosis and Treatment of Pericardial Diseases Section of Cardiovascular Imaging Department of Cardiovascular Medicine Heart, Vascular, and Thoracic InstituteCleveland Clinic Cleveland OH. |
| Jazyk: |
angličtina |
| Zdroj: |
Journal of the American Heart Association [J Am Heart Assoc] 2021 Oct 05; Vol. 10 (19), pp. e021685. Date of Electronic Publication: 2021 Sep 25. |
| DOI: |
10.1161/JAHA.121.021685 |
| Abstrakt: |
Recurrent pericarditis (RP) is a complex inflammatory disorder associated with adverse outcomes and poor quality of life. After the first episode of acute pericarditis, a non-negligible group of patients will fail to achieve complete remission despite treatment and will be challenged by side effects from the chronic use of medications like corticosteroids. The cause of RP remains unknown in the majority of cases, mainly due to a gap in knowledge of its complex pathophysiology. Over the past 2 decades, the interleukin-1 (IL-1) pathway has been uncovered as a key element in the inflammatory cascade, allowing the development of pharmacological targets known as IL-1 inhibitors. This group of medications has emerged as a treatment option for patients with RP colchicine-resistance and steroid dependents. Currently, anakinra and rilonacept, have demonstrated beneficial impact in clinical outcomes with a reasonable safety profile in randomized clinical trials. There is still paucity of data regarding the use of canakinumab in the treatment of patients with RP. Although further studies are needed to refine therapeutic protocols and taper of concomitant therapies, IL-1 inhibitors, continue to consolidate as part of the pharmacological armamentarium to manage this complex condition with potential use as monotherapy. The aim of this review is to highlight the role of IL-1 pathway in RP and discuss the efficacy, safety, and clinical applicability of IL-1 inhibitors in the treatment of RP based on current evidence. |
| Databáze: |
MEDLINE |
| Externí odkaz: |
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