Treatment of Acute Pericarditis With Anakinra
| Status: | Recruiting |
|---|---|
| Conditions: | Cardiology |
| Therapuetic Areas: | Cardiology / Vascular Diseases |
| Healthy: | No |
| Age Range: | 12 - Any |
| Updated: | 4/6/2019 |
| Start Date: | May 11, 2018 |
| End Date: | November 5, 2020 |
| Contact: | Antonio Abbate, MD, PhD |
| Email: | antonio.abbate@vcuhealth.org |
| Phone: | 804-828-0513 |
The goal of this study is to determine the safety and efficacy of anakinra for the treatment
of acute pericarditis when initiated within 6 hours of diagnosis and continued for 3 or 7
days.
1. to determine the efficacy of anakinra with respect to chest pain resolution
2. to determine the safety of anakinra with respect to adverse drug events
of acute pericarditis when initiated within 6 hours of diagnosis and continued for 3 or 7
days.
1. to determine the efficacy of anakinra with respect to chest pain resolution
2. to determine the safety of anakinra with respect to adverse drug events
Acute pericarditis is a clinical syndrome characterized by a profound inflammation of the
membrane tissue that surrounds, supports and protects the heart. Acute pericarditis can be
caused by a variety of infectious and non-infectious agents, but it most commonly either
follows a viral infection of the upper respiratory tract or has no apparent cause.
Acute pericarditis occurs rather abruptly in previously healthy individuals, generally a
child or young adult. Most cases of acute pericarditis resolve within a few days with
non-steroidal anti-inflammatory drugs. However, patients experience severe chest pain and are
at high risk for life-threatening complications involving the pericardium, such as
pericardial tamponade. Acute pericarditis is diagnosed in 1 in 20 (5%) ED visits for chest
pain.
Anakinra (Kineret) has been shown to treat and cure refractory and recurrent pericarditis.
This study is aimed at determining whether anakinra is also effective as first line treatment
in acute pericarditis.
membrane tissue that surrounds, supports and protects the heart. Acute pericarditis can be
caused by a variety of infectious and non-infectious agents, but it most commonly either
follows a viral infection of the upper respiratory tract or has no apparent cause.
Acute pericarditis occurs rather abruptly in previously healthy individuals, generally a
child or young adult. Most cases of acute pericarditis resolve within a few days with
non-steroidal anti-inflammatory drugs. However, patients experience severe chest pain and are
at high risk for life-threatening complications involving the pericardium, such as
pericardial tamponade. Acute pericarditis is diagnosed in 1 in 20 (5%) ED visits for chest
pain.
Anakinra (Kineret) has been shown to treat and cure refractory and recurrent pericarditis.
This study is aimed at determining whether anakinra is also effective as first line treatment
in acute pericarditis.
Inclusion Criteria:
- Age ≥12 years in presence of a parent able to provide consent or age >18 years
- First or recurrent episode of acute pericarditis, defined as the presence of at least
2 of the following:
- Chest pain (suggestive of pericarditis and not explained by another condition)
- Pericardial friction rub on physical exam
- ST-segment elevation and/or PR depression on ECG
- New or worsening pericardial effusion
- Pain of moderate-to-severe intensity (pain score ≥8 on a scale of 0-10 where 0 is no
pain at all and 10 is the worst pain ever experienced) at time on enrollment
- Ability to provide written informed consent if 18 years or older or to provide assent
in presence of parental consent if 12-17 years of age
Exclusion Criteria:
- Pericarditis due to known bacterial or fungal infection
- Pericarditis due to known malignancy
- Pericarditis after cardiac surgery
- Tamponade or need for pericardiocentesis for diagnostic/therapeutic purposes
- Pregnancy or breastfeeding
- Hypersensitivity to anakinra, latex or products derived from Escherichia coli
- Chronic pain syndrome or chronic use of analgesic drugs
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