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AB0021 REAL LIFE DATA ON TAPERING AND DISCONTINUATION OF ANAKINRA TREATMENT IN RECURRENT PERICARDITIS: AN INTERNATIONAL REGISTRY

2023· article· en· W4379649148 on OpenAlexafffundabout
Danilo Malandrino, Alessandra Bettiol, I. Mattioli, Ana Andreis, Luca Cantarini, Lorenzo Dagna, Marzia De Biasio, Marco Gattorno, R Marcolongo, Antonio Tavoni, Ludovico Luca Sicignano, Fabrizio De Benedetti, Antonella Insalaco, Giuseppe Lopalco, Alida L.P. Caforio, Raffaele Manna, Francesco Perna, Gabriele Simonini, Silvia Maestroni, Federica Bello, Allan L. Klein, Vartan Mardigyan, George Lazaros, Andreja Černe, Ana Luís, Massimo Imazio, Antonio Brucato, Giacomo Emmi

Bibliographic record

Venuenot available
Typearticle
Languageen
FieldMedicine
TopicPericarditis and Cardiac Tamponade
Canadian institutionsMcGill UniversityJewish General Hospital
FundersChugai PharmaceuticalUniverza v LjubljaniNational and Kapodistrian University of AthensJewish General HospitalEisaiMcGill UniversityUniversità degli Studi di FirenzeRheumatology Research FoundationUniversità degli Studi di PadovaHospital for Special SurgeryAstraZenecaCleveland ClinicMemorial Sloan-Kettering Cancer CenterPfizer
KeywordsMedicineAnakinraDiscontinuationPericarditisTaperingInternal medicineIntensive care medicineDiseaseComputer science

Abstract

fetched live from OpenAlex

<h3>Background</h3> Recurrent pericarditis (RP) affects up to 30% of patients after a first episode of acute pericarditis. The effectiveness of anakinra, an IL-1 recombinant receptor antagonist (IL-1r), has been established in recent clinical trials and multicenter studies<sup>[1,2</sup><sub>].</sub>Currently the treatment with anakinra is usually prescribed as a third-line option in patients with RP and corticosteroid dependence not responsive to colchicine<sup>[3]</sup>. However, guidance for addressing optimal tapering strategies and discontinuation of biological treatment in RP is limited. <h3>Objectives</h3> To explore key factors for successful anakinra tapering and discontinuation and to investigate potential predictors of disease relapse after complete biologic treatment suspension. <h3>Methods</h3> An international, multicenter, retrospective registry including 18 recruiting centers from five countries (Italy, Greece, Slovenia, Canada, United States) was designed to investigate the disease characteristics of patients with recurrent pericarditis undergoing complete discontinuation of the anti-IL1r therapy anakinra. <h3>Results</h3> A total of 149 patients who had fully discontinued anakinra (59.6% female, median age 51.7 years) were included in the present registry. Most patients had idiopathic aetiology (109; 73.2%) while a first episode of pericarditis after post-cardiac injury syndrome (PCIS) or related to systemic inflammatory diseases was established in 30 and 10 cases (20.1% and 6.7%), respectively, with a median of 3 prior recurrences (interquartile range 2-4). Patients started anakinra treatment after a median time of 12 months (IQR 5-24) after a first episode of acute pericarditis, followed by a period at anakinra full-dosage with a median duration of 6 months (IQR 3–12). Among patients who experienced a recurrence (54 cases; 36.2%), 39 were female (72.2%, <i>p</i> = 0.019). Moreover, we observed a significant reduction in the recurrence of flares after an early introduction of anti-IL-1r treatment from first pericarditis episode (mean median time 10 months; IQR 4-18 vs 14 months; IQR 14-29; <i>p</i> = 0.004). <h3>Conclusion</h3> The main preliminary findings of this global registry suggest that an early introduction of anakinra in patients with RP, corticosteroid-dependent and not responding to colchicine, significantly reduces the recurrence of flares after discontinuation. <h3>References</h3> [1]Brucato A, Imazio M, Gattorno M, et al. Effect of Anakinra on Recurrent Pericarditis Among Patients With Colchicine Resistance and Corticosteroid Dependence: The AIRTRIP Randomized Clinical Trial. JAMA. 2016. [2]Imazio, M., Andreis, A., De Ferrari, G. M., Cremer, P. C., Mardigyan, V., Maestroni, et al. Anakinra for corticosteroid-dependent and colchicine-resistant pericarditis: The IRAP (International Registry of Anakinra for Pericarditis) study. Eur. J. Prev. Cardiol. 2019. [3]Adler Y, Charron P, Imazio M, et al. ESC Scientific Document Group. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases. Eur Heart J. 2015. <h3>Acknowledgements</h3> On behalf of the “International registry of anakinra discontinuation in patients with recurrent pericarditis” <h3>Disclosure of Interests</h3> None Declared.

Fetched live from OpenAlex and de-inverted. Abstracts are not stored in this database: the inverted indexes are 8.6 GB of the frame’s 9.3 GB of text, and the host has 13 GB free.

How this classification was reachedexpand

Full frame distilled prediction

Teacher imitation

Not calibrated prevalence, not ground truth. Human validation pending. Learned from the 10,348 direct Codex labels and 10,348 direct Gemma labels. Candidate is the union of thresholded teacher heads; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels or direct frontier model labels.

metaresearch head score (Codex)0.000
metaresearch head score (Gemma)0.000
Version: codex-gemma-dda1882f352aValidation status: machine_predicted_unvalidated
Candidate categoriesnone
Consensus categoriesnone
DomainCandidate signal: none · Consensus signal: none
Study designCandidate signal: Observational · Consensus signal: Observational
GenreCandidate signal: Empirical · Consensus signal: Empirical
Teacher disagreement score0.483
Threshold uncertainty score0.339

Codex and Gemma teacher scores by category

CategoryCodexGemma
Metaresearch0.0000.000
Meta-epidemiology (narrow)0.0000.000
Meta-epidemiology (broad)0.0000.000
Bibliometrics0.0000.000
Science and technology studies0.0000.000
Scholarly communication0.0000.000
Open science0.0000.000
Research integrity0.0000.000
Insufficient payload (model declined to judge)0.0000.000

Machine scores (provisional)

The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.

Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.

Opus teacher head0.065
GPT teacher head0.363
Teacher spread0.298 · how far apart the two teachers sit on this one work
Validation statusscore_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from it

Classification

machine, unvalidated

Machine predicted; a candidate call from one teacher head, not a consensus.

The models applied no category: nothing in the taxonomy fit this work.
Study designObservational
Domainnot available
GenreEmpirical

How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".

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Citations2
Published2023
Admission routes3
Has abstractyes

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