Use of Interleukin-1 Blockers in Pericardial and Cardiovascular Diseases

  • Giacomo Emmi
  • Maria Letizia Urban
  • Massimo Imazio
  • Marco Gattorno
  • Silvia Maestroni
  • Giuseppe Lopalco
  • Luca Cantarini
  • Domenico Prisco
  • Antonio Brucato
Pericardial Disease (AL Klein, Section Editor)
Part of the following topical collections:
  1. Topical Collection on Pericardial Disease


Purpose of Review

This review aims to summarize the role of the interleukin-1 (IL-1) blocking agents in cardiovascular diseases, briefly describing the pathogenetic rationale and the most relevant clinical studies.

Recent Findings

IL-1 is a pivotal cytokine of the innate immune system. Anti-IL-1 agents are currently used for the treatment of several autoimmune and autoinflammatory conditions. Recently, the role of IL-1 has also emerged in cardiovascular diseases. Indeed, two recent randomized controlled trials have shown that the IL-1 receptor antagonist anakinra is effective for the treatment of idiopathic recurrent pericarditis and the IL-1β blocking agent canakinumab is effective in reducing myocardial infarction in people at risk. Interestingly, interfering with IL-1 has proved to be also effective in other cardiovascular manifestations, such as myocarditis, arrhythmias, and heart failure.


Blocking the IL-1 pathway is a possible new therapeutic strategy, potentially leading to innovative therapies in many acute and chronic cardiovascular diseases.


Interleukin-1 Anakinra Canakinumab Pericarditis Atherosclerosis Cardiovascular disease 





Nucleotide-binding domain


Nucleotide-binding domain-like receptor


Caspase activation recruitment domain


Absent in melanoma


Nucleotide-binding domain, leucine-rich-containing family, pyrin domain-containing


NLR-CARD (caspase activating and recruitment domain) containing


Pathogen-associated molecular patterns


Damage-associated molecular patterns


Toll/interleukin-1 receptor


Myeloid differentiation primary response protein 88


Nuclear factor-kb


Mitogen-activated protein kinase


Rheumatoid arthritis


Cryopyrin-associated periodic syndromes


Idiopathic recurrent pericarditis


Tumor necrosis factor receptor-1-associated periodic syndrome


Anakinra treatment of recurrent idiopathic pericarditis


Non-steroidal anti-inflammatory drugs


Anakinra (recombinant human interleukin-1 receptor antagonist) in heart failure


C-reactive protein


Acute decompensated heart failure


Heart failure


Left ventricle ejection fraction


Decompensated Heart failure Anakinra Response Trial


HF and preserved ejection fraction


New York Heart Association


Recently Decompensated Heart failure Anakinra Response Trial


Myocardial infarction


Coronary artery disease


Virginia Commonwealth University - Anakinra Remodeling Trial


ST segment elevation


Magnetic resonance


Corrected QT


Atrial fibrillation


familial Mediterranean fever


Canakinumab Anti-inflammatory Thrombosis Outcome Study




Compliance with Ethical Standards

Conflict of Interest

Giacomo Emmi has received personal fees for consultancy from GSK and for advisory board from Novartis.

Maria Letizia Urban and Silvia Maestroni declare that they have no conflict of interest.

Massimo Imazio has received an Institutional Grant for Clinical Research from SOBI.

Marco Gattorno has received fees and unrestricted grants from SOBI and Novartis.

Giuseppe Lopalco has received speaker fees from Novartis and SOBI.

Luca Cantarini has received personal fees from Novartis and SOBI.

Domenico Prisco has received grants for advisory boards from Bayer, Daichi Sankyo, Boehringer Ingelheim, BMS Pfizer, and Baxter.

Antonio Brucato has received unrestricted grants from ACARPIA and SOBI and for advisory board from SOBI.

Human and Animal Rights and Informed Consent

This article does not contain any studies with human or animal subjects performed by any of the authors.


Papers of particular interest, published recently, have been highlighted as: • Of importance•• Of major Importance

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Copyright information

© Springer Science+Business Media, LLC, part of Springer Nature 2018

Authors and Affiliations

  • Giacomo Emmi
    • 1
  • Maria Letizia Urban
    • 2
  • Massimo Imazio
    • 3
  • Marco Gattorno
    • 4
  • Silvia Maestroni
    • 5
  • Giuseppe Lopalco
    • 6
  • Luca Cantarini
    • 7
  • Domenico Prisco
    • 1
  • Antonio Brucato
    • 5
  1. 1.Department of Experimental and Clinical MedicineUniversity of FirenzeFlorenceItaly
  2. 2.Nephrology UnitUniversity Hospital of ParmaParmaItaly
  3. 3.University Cardiology, Cardiovascular and Thoracic DepartmentAOU Città della Salute e della Scienza of TorinoTurinItaly
  4. 4.Clinic of Pediatrics and Rheumatology, Unit of Autoinflammatory Diseases and Immunodeficiencies“G. Gaslini” InstituteGenoaItaly
  5. 5.Internal MedicineOspedale Papa Giovanni XXIIIBergamoItaly
  6. 6.Department of Emergency and Organ Transplantation, Rheumatology UnitBariItaly
  7. 7.Research Center of Systemic Autoinflammatory Diseases, Behçet’s Disease Clinic and Rheumatology-Ophthalmology Collaborative Uveitis CenterUniversity of SienaSienaItaly

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