Interleukin-1 Blockers in Recurrent and Acute Pericarditis: State of the Art and Future Directions
Abstract
:1. Introduction
2. Etiology and Current Treatment of Acute and Recurrent Pericarditis
3. The Inflammasome Complex: A Key Player in Pericardial Inflammation
4. Interleukin-1 Blockers in Recurrent Pericarditis
4.1. Anakinra
4.2. Rilonacept
4.3. Canakinumab
4.4. Goflikicept
5. Interleukin-1 Blockers in Acute Pericarditis
6. Conclusions
Author Contributions
Funding
Institutional Review Board Statement
Informed Consent Statement
Data Availability Statement
Conflicts of Interest
References
- Bizzi, E.; Picchi, C.; Mastrangelo, G.; Imazio, M.; Brucato, A. Recent advances in pericarditis. Eur. J. Intern. Med. 2022, 95, 24–31. [Google Scholar] [CrossRef]
- Adler, Y.; Charron, P.; Imazio, M.; Badano, L.; Barón-Esquivias, G.; Bogaert, J.; Brucato, A.; Gueret, P.; Klingel, K.; Lionis, C.; et al. 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: The Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: The European Association for Cardio-Thoracic Surgery (EACTS). Eur. Heart J. 2015, 36, 2921–2964. [Google Scholar]
- Chiabrando, J.G.; Bonaventura, A.; Vecchié, A.; Wohlford, G.F.; Mauro, A.G.; Jordan, J.H.; Grizzard, J.D.; Montecucco, F.; Berrocal, D.H.; Brucato, A.; et al. Management of Acute and Recurrent Pericarditis. J. Am. Coll. Cardiol. 2020, 75, 76–92. [Google Scholar] [CrossRef]
- Fairweather, D.; Beetler, D.J.; Di Florio, D.N.; Musigk, N.; Heidecker, B.; Cooper, L.T. COVID-19, Myocarditis and Pericarditis. Circ. Res. 2023, 132, 1302–1319. [Google Scholar] [CrossRef]
- Kumar, S.; Khubber, S.; Reyaldeen, R.; Agrawal, A.; Cremer, P.C.; Imazio, M.; Kwon, D.H.; Klein, A.L. Advances in Imaging and Targeted Therapies for Recurrent Pericarditis: A Review. JAMA Cardiol. 2022, 7, 975–985. [Google Scholar] [CrossRef]
- Cabrera-Rego, J.O.; Rojas-Quiroz, A.F.; Vidal-Turruelles, Y.; Yanes-Quintana, A.A. Cardiovascular disorders in hospitalized patients with dengue infection. Enfermedades Infecc. Microbiol. Clin. (Engl. Ed.) 2021, 39, 115–118. [Google Scholar] [CrossRef]
- Diaz, G.A.; Parsons, G.T.; Gering, S.K.; Meier, A.R.; Hutchinson, I.V.; Robicsek, A. Myocarditis and Pericarditis After Vaccination for COVID-19. JAMA 2021, 326, 1210–1212. [Google Scholar] [CrossRef] [PubMed]
- Pepe, S.; Gregory, A.T.; Denniss, A.R. Myocarditis, Pericarditis and Cardiomyopathy After COVID-19 Vaccination. Heart Lung Circ. 2021, 30, 1425–1429. [Google Scholar] [CrossRef] [PubMed]
- Gouriet, F.; Levy, P.-Y.; Casalta, J.-P.; Zandotti, C.; Collart, F.; Lepidi, H.; Cautela, J.; Bonnet, J.L.; Thuny, F.; Habib, G.; et al. Etiology of Pericarditis in a Prospective Cohort of 1162 Cases. Am. J. Med. 2015, 128, 784.e1–784.e8. [Google Scholar] [CrossRef]
- Bouriche, F.; Toro, A.; Negre, V.; Yvorra, S. Acute Pericarditis: Aetiologic Diagnosis and Practical Aspect of the Management. Curr. Probl. Cardiol. 2021, 46, 100769. [Google Scholar] [CrossRef] [PubMed]
- Imazio, M.; Spodick, D.H.; Brucato, A.; Trinchero, R.; Adler, Y. Controversial Issues in the Management of Pericardial Diseases. Circulation 2010, 121, 916–928. [Google Scholar] [CrossRef]
- Imazio, M.; Gaita, F. Diagnosis and treatment of pericarditis. Heart 2015, 101, 1159–1168. [Google Scholar] [CrossRef] [PubMed]
- Imazio, M.; Brucato, A.; Cemin, R.; Ferrua, S.; Maggiolini, S.; Beqaraj, F.; Demarie, D.; Forno, D.; Ferro, S.; Maestroni, S.; et al. A Randomized Trial of Colchicine for Acute Pericarditis. N. Engl. J. Med. 2013, 369, 1522–1528. [Google Scholar] [CrossRef] [PubMed]
- Papageorgiou, N.; Briasoulis, A.; Lazaros, G.; Imazio, M.; Tousoulis, D. Colchicine for prevention and treatment of cardiac diseases: A meta-analysis. Cardiovasc. Ther. 2017, 35, 10–18. [Google Scholar] [CrossRef] [PubMed]
- Lazaros, G.; Antonopoulos, A.S.; Vlachopoulos, C.; Oikonomou, E.; Karavidas, A.; Chrysochoou, C.; Lazarou, E.; Vassilopoulos, D.; Imazio, M.; Tousoulis, D. Predictors of switching from nonsteroidal anti-inflammatory drugs to corticosteroids in patients with acute pericarditis and impact on clinical outcome. Hell. J. Cardiol. HJC Hell Kardiologike Epitheorese 2019, 60, 357–363. [Google Scholar] [CrossRef]
- Lopalco, G.; Rigante, D.; Cantarini, L.; Imazio, M.; Lopalco, A.; Emmi, G.; Venerito, V.; Fornaro, M.; Frediani, B.; Nivuori, M.; et al. The autoinflammatory side of recurrent pericarditis: Enlightening the pathogenesis for a more rational treatment. Trends Cardiovasc. Med. 2021, 31, 265–274. [Google Scholar] [CrossRef]
- Tombetti, E.; Giani, T.; Brucato, A.; Cimaz, R. Recurrent Pericarditis in Children and Adolescents. Front. Pediatr. 2019, 7, 419. [Google Scholar] [CrossRef]
- Lazaros, G.; Karavidas, A.; Spyropoulou, M.; Tsiachris, D.; Halapas, A.; Zacharoulis, A.; Arapi, S.; Matzaraki, V.; Papadopoulos, K.; Korres, D.; et al. The Role of the Immunogenetic Background in the Development and Recurrence of Acute Idiopathic Pericarditis. Cardiology 2011, 118, 55–62. [Google Scholar] [CrossRef]
- Imazio, M.; Brucato, A.; Pluymaekers, N.; Breda, L.; Calabri, G.; Cantarini, L.; Cimaz, R.; Colimodio, F.; Corona, F.; Cumetti, D.; et al. Recurrent pericarditis in children and adolescents: A multicentre cohort study. J. Cardiovasc. Med. Hagerstown Md. 2016, 17, 707–712. [Google Scholar] [CrossRef]
- Maestroni, S.; Di Corato, P.R.; Cumetti, D.; Chiara, D.B.L.C.; Ghidoni, S.; Prisacaru, L.; Cantarini, L.; Imazio, M.; Penco, S.; Pedrotti, P.; et al. Recurrent pericarditis: Autoimmune or autoinflammatory? Autoimmun. Rev. 2012, 12, 60–65. [Google Scholar] [CrossRef]
- Park, H.; Bourla, A.B.; Kastner, D.L.; Colbert, R.A.; Siegel, R.M. Lighting the fires within: The cell biology of autoinflammatory diseases. Nat. Rev. Immunol. 2012, 12, 570–580. [Google Scholar] [CrossRef]
- Swanson, K.V.; Deng, M.; Ting, J.P.-Y. The NLRP3 inflammasome: Molecular activation and regulation to therapeutics. Nat. Rev. Immunol. 2019, 19, 477–489. [Google Scholar] [CrossRef]
- Kaneko, N.; Kurata, M.; Yamamoto, T.; Morikawa, S.; Masumoto, J. The role of interleukin-1 in general pathology. Inflamm. Regen. 2019, 39, 12. [Google Scholar] [CrossRef]
- Van Kempen, T.S.; Wenink, M.H.; Leijten, E.F.A.; Radstake, T.R.D.J.; Boes, M. Perception of self: Distinguishing autoimmunity from autoinflammation. Nat. Rev. Rheumatol. 2015, 11, 483–492. [Google Scholar] [CrossRef]
- Dinarello, C.A. Interleukin-1 in the pathogenesis and treatment of inflammatory diseases. Blood 2011, 117, 3720–3732. [Google Scholar] [CrossRef]
- Bertheloot, D.; Latz, E. HMGB1, IL-1α, IL-33 and S100 proteins: Dual-function alarmins. Cell Mol. Immunol. 2017, 14, 43–64. [Google Scholar] [CrossRef] [PubMed]
- Insalaco, A.; Prencipe, G.; Buonuomo, P.S.; Ceccherini, I.; Bracaglia, C.; Pardeo, M.; Nicolai, R.; De Benedetti, F. A novel mutation in the CIAS1/NLRP3 gene associated with an unexpected phenotype of cryopyrin-associated periodic syndromes. Clin. Exp. Rheumatol. 2014, 32, 123–125. [Google Scholar] [PubMed]
- Mauro, A.G.; Bonaventura, A.; Vecchié, A.; Mezzaroma, E.; Carbone, S.; Narayan, P.; Potere, N.; Cannatà, A.; Paolini, J.F.; Bussani, R.; et al. The Role of NLRP3 Inflammasome in Pericarditis: Potential for Therapeutic Approaches. JACC Basic Transl. Sci. 2021, 6, 137–150. [Google Scholar] [CrossRef] [PubMed]
- Masters, S.L.; Simon, A.; Aksentijevich, I.; Kastner, D.L. Horror Autoinflammaticus: The Molecular Pathophysiology of Autoinflammatory Disease. Annu. Rev. Immunol. 2009, 27, 621–668. [Google Scholar] [CrossRef] [PubMed]
- Ozen, S.; Demirkaya, E.; Erer, B.; Livneh, A.; Ben-Chetrit, E.; Giancane, G.; Ozdogan, H.; Abu, I.; Gattorno, M.; Hawkins, P.N.; et al. EULAR recommendations for the management of familial Mediterranean fever. Ann. Rheum. Dis. 2016, 75, 644–651. [Google Scholar] [CrossRef] [PubMed]
- McDermott, M.F.; Aksentijevich, I.; Galon, J.; McDermott, E.M.; Ogunkolade, B.; Centola, M.; Mansfield, E.; Gadina, M.; Karenko, L.; Pettersson, T.; et al. Germline Mutations in the Extracellular Domains of the 55 kDa TNF Receptor, TNFR1, Define a Family of Dominantly Inherited Autoinflammatory Syndromes. Cell 1999, 97, 133–144. [Google Scholar] [CrossRef]
- Gerfaud-Valentin, M.; Jamilloux, Y.; Iwaz, J.; Sève, P. Adult-onset Still’s disease. Autoimmun. Rev. 2014, 13, 708–722. [Google Scholar] [CrossRef]
- Aksentijevich, I.; Masters, S.L.; Ferguson, P.J.; Dancey, P.; Frenkel, J.; Van Royen-Kerkhoff, A.; Laxer, R.; Tedgård, U.; Cowen, E.W.; Pham, T.-H.; et al. An Autoinflammatory Disease with Deficiency of the Interleukin-1–Receptor Antagonist. N. Engl. J. Med. 2009, 360, 2426–2437. [Google Scholar] [CrossRef]
- Toro, J.R.; Aksentijevich, I.; Hull, K.; Dean, J.; Kastner, D.L. Tumor Necrosis Factor Receptor–Associated Periodic Syndrome: A novel syndrome with cutaneous manifestations. Arch Dermatol. 2000, 136, 1487–1494. [Google Scholar] [CrossRef] [PubMed]
- Granowitz, E.V.; Porat, R.; Mier, J.W.; Pribble, J.P.; Stiles, D.M.; Bloedow, D.C.; Catalano, M.A.; Wolff, S.M.; Dinarello, C.A. Pharmacokinetics, safety and immunomodulatory effects of human recombinant interleukin-1 receptor antagonist in healthy humans. Cytokine 1992, 4, 353–360. [Google Scholar] [CrossRef] [PubMed]
- Yang, B.; Baughman, S.; Sullivan, J.T. Pharmacokinetics of anakinra in subjects with different levels of renal function. Clin. Pharmacol. Ther. 2003, 74, 85–94. [Google Scholar] [CrossRef] [PubMed]
- Arnold, D.D.; Yalamanoglu, A.; Boyman, O. Systematic Review of Safety and Efficacy of IL-1-Targeted Biologics in Treating Immune-Mediated Disorders. Front. Immunol. 2022, 13, 888392. [Google Scholar] [CrossRef] [PubMed]
- Rovina, N.; Akinosoglou, K.; Eugen-Olsen, J.; Hayek, S.; Reiser, J.; Giamarellos-Bourboulis, E.J. Soluble urokinase plasminogen activator receptor (suPAR) as an early predictor of severe respiratory failure in patients with COVID-19 pneumonia. Crit. Care 2020, 24, 187. [Google Scholar] [CrossRef] [PubMed]
- Brucato, A.; Imazio, M.; Gattorno, M.; Lazaros, G.; Maestroni, S.; Carraro, M.; Finetti, M.; Cumetti, D.; Carobbio, A.; Ruperto, N.; et al. Effect of Anakinra on Recurrent Pericarditis Among Patients with Colchicine Resistance and Corticosteroid Dependence: The AIRTRIP Randomized Clinical Trial. JAMA 2016, 316, 1906–1912. [Google Scholar] [CrossRef] [PubMed]
- Imazio, M.; Andreis, A.; De Ferrari, G.M.; Cremer, P.C.; Mardigyan, V.; Maestroni, S.; Luis, S.A.; Lopalco, G.; Emmi, G.; Lotan, D.; et al. Anakinra for corticosteroid-dependent and colchicine-resistant pericarditis: The IRAP (International Registry of Anakinra for Pericarditis) study. Eur. J. Prev. Cardiol. 2019, 27, 956–964. [Google Scholar] [CrossRef] [PubMed]
- Buckley, L.F.; Viscusi, M.M.; Van Tassell, B.W.; Abbate, A. Interleukin-1 blockade for the treatment of pericarditis. Eur. Heart J. Cardiovasc. Pharmacother. 2018, 4, 46–53. [Google Scholar] [CrossRef] [PubMed]
- Andreis, A.; Imazio, M.; Casula, M.; Avondo, S.; Brucato, A. Recurrent pericarditis: An update on diagnosis and management. Intern. Emerg. Med. 2021, 16, 551–558. [Google Scholar] [CrossRef]
- Autmizguine, J.; Cohen-Wolkowiez, M.; Ilowite, N.; RAPPORT Investigators. Rilonacept pharmacokinetics in children with systemic juvenile idiopathic arthritis. J. Clin. Pharmacol. 2015, 55, 39–44. [Google Scholar] [CrossRef] [PubMed]
- Radin, A.; Marbury, T.; Osgood, G.; Belomestnov, P. Safety and Pharmacokinetics of Subcutaneously Administered Rilonacept in Patients With Well-Controlled End-Stage Renal Disease (ESRD). J. Clin. Pharmacol. 2010, 50, 835–841. [Google Scholar] [CrossRef]
- Church, L.D.; Savic, S.; McDermott, M.F. Long term management of patients with cryopyrin-associated periodic syndromes (CAPS): Focus on rilonacept (IL-1 Trap). Biol. Targets Ther. 2008, 2, 733–742. [Google Scholar] [CrossRef] [PubMed]
- Klein, A.L.; Imazio, M.; Cremer, P.; Brucato, A.; Abbate, A.; Fang, F.; Insalaco, A.; LeWinter, M.; Lewis, B.S.; Lin, D.; et al. Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. N. Engl. J. Med. 2021, 384, 31–41. [Google Scholar] [CrossRef] [PubMed]
- Chakraborty, A.; Tannenbaum, S.; Rordorf, C.; Lowe, P.J.; Floch, D.; Gram, H.; Roy, S. Pharmacokinetic and Pharmacodynamic Properties of Canakinumab, a Human Anti-Interleukin-1β Monoclonal Antibody. Clin. Pharmacokinet. 2012, 51, e1–e18. [Google Scholar] [CrossRef]
- Kuemmerle-Deschner, J.B.; Ramos, E.; Blank, N.; Roesler, J.; Felix, S.D.; Jung, T.; Stricker, K.; Chakraborty, A.; Tannenbaum, S.; Wright, A.M.; et al. Canakinumab (ACZ885, a fully human IgG1 anti-IL-1β mAb) induces sustained remission in pediatric patients with cryopyrin-associated periodic syndrome (CAPS). Arthritis Res. Ther. 2011, 13, R34. [Google Scholar] [CrossRef]
- Gül, A.; Ozdogan, H.; Erer, B.; Ugurlu, S.; Kasapcopur, O.; Davis, N.; Sevgi, S. Efficacy and safety of canakinumab in adolescents and adults with colchicine-resistant familial Mediterranean fever. Arthritis Res. Ther. 2015, 17, 243. [Google Scholar] [CrossRef]
- Theodoropoulou, K.; von Scheven-Gête, A.; Bressieux-Degueldre, S.; Prsa, M.; Angelini, F.; Boulos, T.; Hofer, M. A case of corticosteroid-dependent recurrent pericarditis with different response to two IL-1 blocking agents. Pediatr. Rheumatol. 2015, 13, P155. [Google Scholar] [CrossRef]
- Kougkas, N.; Fanouriakis, A.; Papalopoulos, I.; Bertsias, G.; Avgoustidis, N.; Repa, A.; Sidiropoulos, P. Canakinumab for recurrent rheumatic disease associated-pericarditis: A case series with long-term follow-up. Rheumatology 2018, 57, 1494–1495. [Google Scholar] [CrossRef] [PubMed]
- Epçaçan, S.; Sahin, S.; Kasapcopur, O. Anaphylactic reaction to anakinra in a child with steroid-dependent idiopathic recurrent pericarditis and successful management with canakinumab. Cardiol. Young 2019, 29, 549–551. [Google Scholar] [CrossRef] [PubMed]
- Signa, S.; D’alessandro, M.; Consolini, R.; Miniaci, A.; Bustaffa, M.; Longo, C.; Tosca, M.A.; Bizzi, M.; Caorsi, R.; Mendonça, L.O.; et al. Failure of anti Interleukin-1 β monoclonal antibody in the treatment of recurrent pericarditis in two children. Pediatr. Rheumatol. 2020, 18, 51. [Google Scholar] [CrossRef]
- Chawla, S.; Lak, H.M.; Furqan, M.; Klein, A. Use of canakinumab (illaris) for the management of autoimmune mediated recurrent pericarditis. J. Am. Coll. Cardiol. 2021, 77, 1874. [Google Scholar] [CrossRef]
- Caorsi, R.; Insalaco, A.; Bovis, F.; Martini, G.; Cattalini, M.; Chinali, M.; Rimini, A.; Longo, C.; Federici, S.; Celani, C.; et al. Pediatric Recurrent Pericarditis: Appropriateness of the Standard of Care and Response to IL-1 Blockade. J Pediatr. 2023, 256, 18–26. [Google Scholar] [CrossRef]
- Myachikova, V.Y.; Maslyanskiy, A.L.; Moiseeva, O.M.; Vinogradova, O.V.; Gleykina, E.V.; Lavrovsky, Y.; Abbate, A.; Grishin, S.A.; Egorova, A.N.; Schedrova, M.L.; et al. Treatment of Idiopathic Recurrent Pericarditis with Goflikicept: Phase II/III Study Results. J. Am. Coll. Cardiol. 2023, 82, 30–40. [Google Scholar] [CrossRef] [PubMed]
- Wohlford, G.F.; Buckley, L.F.; Vecchié, A.; Kadariya, D.; Markley, R.; Trankle, C.R.; Chiabrando, J.G.; de Chazal, H.M.; Van Tassell, B.; Abbate, A. Acute Effects of Interleukin-1 Blockade Using Anakinra in Patients with Acute Pericarditis. J. Cardiovasc. Pharmacol. 2020, 76, 50–52. [Google Scholar] [CrossRef]
- Shaukat, M.H.; Singh, S.; Davis, K.; Torosoff, M.; Peredo-Wende, R. Efficacy of anakinra for idiopathic and non-idiopathic pericarditis refractory or intolerant to conventional therapy. Eur. Heart J. Acute Cardiovasc. Care 2020, 9, 888–892. [Google Scholar] [CrossRef]
- Sicignano, L.L.; Massaro, M.G.; Savino, M.; Rigante, D.; Gerardino, L.; Manna, R. Early introduction of anakinra improves acute pericarditis and prevents tamponade in Staphylococcal sepsis. Intern. Emerg. Med. 2021, 16, 1391–1394. [Google Scholar] [CrossRef]
- Perna, F.; Verecchia, E.; Pinnacchio, G.; Gerardino, L.; Brucato, A.; Manna, R. Rapid resolution of severe pericardial effusion using anakinra in a patient with COVID-19 vaccine-related acute pericarditis relapse: A case report. Eur. Heart J. Case Rep. 2022, 6, ytac123. [Google Scholar] [CrossRef]
- Massaro, M.G.; Gallo, A.; Montalto, M.; Manna, R.; Gemelli-Against-Pericarditis Group. Treatment of recurrent pericarditis in elderly. Eur. J. Intern. Med. 2023, 112, 133–135. [Google Scholar] [CrossRef] [PubMed]
Drugs | Mechanism | Indications | Note |
---|---|---|---|
Aspirin | COX inhibition | First line | As an adjunct to colchicine |
Ibuprofene | COX inhibition | First line | As an adjunct to colchicine |
Indomethacin | COX inhibition | First line | As an adjunct to colchicine |
Colchicine | Inhibition of inflammasome and neutrophil functions | First line | As an adjunct to NSAIDs |
Corticosteroids | Antinflammatory and Immunosuppressive action | Second line | If NSAIS/colchicine are contraindicated and after exclusion of infectious causes |
Anakinra | IL-1 receptor antagonist | Third line | In cases of corticosteroid-dependent recurrent pericarditis in patients not responsive to colchicine |
Azathioprine | Purine synthesis inhibitor | Third line | In cases of corticosteroid-dependent recurrent pericarditis in patients not responsive to colchicine |
Immunoglobulins | Immunomodulatory and anti-infective agents | Third line | In cases of corticosteroid-dependent recurrent pericarditis in patients not responsive to colchicine |
Drug | Study | Design | Year | Pts n. | Dose | Results | AE |
---|---|---|---|---|---|---|---|
Anakinra | AIRTRIP | PT | 2016 | 21 | 2 mg/kg/day | ↓ recurrence | ISR; ↑ALT; ↑AST |
IRAP | PT | 2020 | 224 | 100 mg/day | ↓ recurrence | ISR; A; M | |
Rilonacept | RHAPSODY II | PT | 2020 | 25 | 320 mg LD and then 160 mg/week | ↓ recurrence | ISR; I |
RHAPSODY III | PT | 2021 | 86 | 320 mg LD 160 mg/week | ↓ recurrence | ISR; URTI | |
Canakinumab | Theodoropoulou | CR | 2015 | 1 | 2 mg/kg/month and then 4 mg/kg/month | Relapse | Unreported |
Kougkas | CR | 2018 | 3 | 150/mg/month | Remission (2 Pts) Relapse (1 Pts) | Unreported | |
Epçaçan | CR | 2019 | 1 | 5 mg/kg/month | Remission | None | |
Signa | CR | 2020 | 2 | 2.5 mg/kg/month or 4 mg/kg/month | Relapse | Unreported | |
Chawla | CR | 2021 | 1 | Unknown | Remission | Unreported |
Drug | Study | Design | Year | Pts n. | Dose | Results | AE |
---|---|---|---|---|---|---|---|
Anakinra | Wohlford | COLT | 2020 | 5 | 100 mg single dose | ↓ pain ↓ WBC | None |
Shaukat | RS | 2020 | 8 | 100 mg no tapering | ↓ symptoms ↓ HS | None | |
Sicignano | CR | 2021 | 1 | 100 mg for 5 days | ↓ effusion Pericardiocentesis avoided | None | |
Perna | CR | 2022 | 1 | 100 mg/day with tapering | ↓ symptoms ↓ inflammation | None | |
Massaro | CS | 2023 | 5 | 100 mg/day with tapering | Stable remission | None |
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Gallo, A.; Massaro, M.G.; Camilli, S.; Di Francesco, S.; Gerardino, L.; Verrecchia, E.; Sicignano, L.L.; Landi, F.; Manna, R.; Montalto, M. Interleukin-1 Blockers in Recurrent and Acute Pericarditis: State of the Art and Future Directions. Medicina 2024, 60, 241. https://doi.org/10.3390/medicina60020241
Gallo A, Massaro MG, Camilli S, Di Francesco S, Gerardino L, Verrecchia E, Sicignano LL, Landi F, Manna R, Montalto M. Interleukin-1 Blockers in Recurrent and Acute Pericarditis: State of the Art and Future Directions. Medicina. 2024; 60(2):241. https://doi.org/10.3390/medicina60020241
Chicago/Turabian StyleGallo, Antonella, Maria Grazia Massaro, Sara Camilli, Silvino Di Francesco, Laura Gerardino, Elena Verrecchia, Ludovico Luca Sicignano, Francesco Landi, Raffaele Manna, and Massimo Montalto. 2024. "Interleukin-1 Blockers in Recurrent and Acute Pericarditis: State of the Art and Future Directions" Medicina 60, no. 2: 241. https://doi.org/10.3390/medicina60020241