AIRTRIP
Anakinra-Treatment of Recurrent Idiopathic Pericarditis
Patient / Population Intervention / Exposure Comparison Outcome
In 21 patients with colchicine-resistant, corticosteroid-dependent recurrent pericarditis, continued anakinra markedly reduced recurrent pericarditis after randomised withdrawal compared with a switch to placebo.
N
21patients
Design
Double-blind randomised-withdrawal RCT after an open-label run-in
Endpoint
Recurrent pericarditis and time to recurrence after randomisation
Relevance
3Supporting — context rather than must-know.
Result18.2 % vs 90 %; median flare-free survival 72 days on placebo and not reached with anakinra (p<0.001). Transient injection-site reactions in 95.2 %.
Brucato A, Imazio M, Gattorno M, et al. JAMA. 2016;316(18):1906-1912. 10.1001/jama.2016.15826
Cited in guidelines
Discussion & critique
Tiny, single-country, and the randomised-withdrawal design enriches for responders, so the effect size is almost certainly inflated. It was the first randomised proof that interleukin-1 blockade breaks the corticosteroid-dependency cycle.