{ "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]; P =0.001 and HR, 0.48 [95% CI, 0.23–0.86]; P =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.", "abstract_shown": true, "affiliations": [ "University of Florence", "University Cardiology, AOU Città della Salute e della Scienza di Torino", "AOU Città della Salute e della Scienza di Torino", "University of Padua", "University of Siena", "University Medical Center Ljubljana", "Italy and Vita‐Salute San Raffaele University", "Ospedale Pediatrico Bambino Gesù IRCCS, ERN‐RITA Center", "IRCCS Istituto Giannina Gaslini", "Cleveland Clinic", "National and Kapodistrian University of Athens School of Medicine", "University of Bari “Aldo Moro”", "Mayo Clinic", "Papa Giovanni XXIII Hospital", "Università Cattolica Sacro Cuore", "Jewish General Hospital", "Meyer Children's Hospital IRCCS", "University of Pisa", "ASUFC, Piazzale Santa Maria della Misericordia", "University of Udine", "University of Milan", "Immunology and Allergy Service, University of Lausanne", "Surgical and Health Sciences, University of Trieste", "Department of Medicine, Monash University, Monash Medical Centre" ], "article_type": null, "arxiv": null, "author_total": 34, "authors": [ { "affs": [ 0 ], "name": "Danilo Malandrino", "orcid": "0000-0002-1053-5178" }, { "affs": [ 0 ], "name": "Alessandra Bettiol" }, { "affs": [ 1, 2 ], "name": "Alessandro Andreis", "orcid": "0000-0002-1203-000X" }, { "affs": [ 1 ], "name": "Gaetano M. De Ferrari", "orcid": "0000-0003-4940-0876" }, { "affs": [ 1 ], "name": "Luca Scudeler" }, { "affs": [ 1 ], "name": "Alessandra Agosti" }, { "affs": [ 3 ], "name": "Alida L. P. Caforio", "orcid": "0000-0002-4901-5655" }, { "affs": [ 0 ], "name": "Maria Canfora", "orcid": "0009-0008-2643-4102" }, { "affs": [ 4 ], "name": "Luca Cantarini", "orcid": "0000-0002-7352-1275" }, { "affs": [ 5 ], "name": "Andreja C. Cercek" }, { "affs": [ 6 ], "name": "Lorenzo Dagna", "orcid": "0000-0002-7428-315X" }, { "affs": [ 7 ], "name": "Antonella Insalaco", "orcid": "0000-0003-1443-1840" }, { "affs": [ 8 ], "name": "Marco Gattorno", "orcid": "0000-0003-0704-1916" }, { "affs": [ 8 ], "name": "Roberta Caorsi", "orcid": "0000-0003-0131-7846" }, { "affs": [ 9 ], "name": "Allan Klein", "orcid": "0000-0001-9240-8369" }, { "affs": [ 10 ], "name": "George Lazaros", "orcid": "0000-0003-2802-9617" }, { "affs": [ 11 ], "name": "Giuseppe Lopalco", "orcid": "0000-0003-4524-9566" }, { "affs": [ 12 ], "name": "Sushil A. Luis", "orcid": "0000-0001-9821-1225" }, { "affs": [ 13 ], "name": "Silvia Maestroni", "orcid": "0000-0002-9398-8366" }, { "affs": [ 0 ], "name": "Irene Mattioli", "orcid": "0000-0003-2995-6113" }, { "affs": [ 14 ], "name": "Raffaele Manna", "orcid": "0000-0003-1560-3907" }, { "affs": [ 15 ], "name": "Vartan Mardigyan" }, { "affs": [ 16 ], "name": "Gabriele Simonini" }, { "affs": [ 0 ], "name": "Elena Silvestri", "orcid": "0000-0001-9719-2106" }, { "affs": [ 17 ], "name": "Antonio Tavoni" }, { "affs": [ 18, 19 ], "name": "Massimo Imazio", "orcid": "0000-0002-5722-0245" }, { "affs": [ 20 ], "name": "Antonio Brucato", "orcid": "0000-0002-7566-5600" }, { "affs": [ 21, 22, 23 ], "name": "Giacomo Emmi", "orcid": "0000-0001-9575-8321" }, { "name": "Fabrizio De Benedetti" }, { "name": "Emilia Lazarou" }, { "name": "Ludovico Luca Sicignano" }, { "name": "Alessandro De Matteis" }, { "name": "Anna Baritussio" }, { "name": "Andrea Silvio Giordani" } ], "bibtex": "https://research.draconitic.com/paper/4xsb5550yfdw0.bib", "cited_by": 0, "doi": "10.1161/jaha.126.050181", "fulltext_url": null, "id": "4xsb5550yfdw0", "issns": [ "2047-9980" ], "landing_url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.050181", "language": null, "licence": "CC-BY-NC-ND", "licence_label": "CC BY-NC-ND", "licence_source": "journal", "licence_url": "https://creativecommons.org/licenses/by-nc-nd/4.0/", "metadata_licence": null, "native_subjects": [ [ "openalex", "2705|Pericarditis and Cardiac Tamponade" ] ], "openalex": "W7222480086", "pdf_url": null, "pmcid": null, "pmid": null, "published": "2026-10-20", "publisher": "Ovid Technologies (Wolters Kluwer Health)", "ris": "https://research.draconitic.com/paper/4xsb5550yfdw0.ris", "sources": [ { "first_seen": "2026-10-30T12:20:28Z", "native_id": "10.1161/jaha.126.050181", "source": "crossref", "url": "https://www.ahajournals.org/doi/10.1161/JAHA.126.050181" } ], "subjects": [ { "field": "medicine", "origin": "openalex:2705|Pericarditis and Cardiac Tamponade", "subfield": "cardiovascular" } ], "title": "Early Introduction and Prolonged Full‐Dose Anakinra Reduce Recurrence Risk After Discontinuation in Recurrent Pericarditis: An International Multicenter Cohort", "title_text": "Early Introduction and Prolonged Full‐Dose Anakinra Reduce Recurrence Risk After Discontinuation in Recurrent Pericarditis: An International Multicenter Cohort", "type": "peer-reviewed", "updated_at": "2026-10-30T12:20:28Z", "url": "https://research.draconitic.com/paper/4xsb5550yfdw0", "venue": "Journal of the American Heart Association", "versions": [] }