Andreis A, Imazio M, Giustetto C, et al. - Given that a risk for constrictive pericarditis (CP) may be conferred by frequent flares of pericardial inflammation in recurrent or incessant pericarditis with corticosteroid dependence and colchicine resistance, so, researchers focused on the identification of CP in these patients, assessing whether anakinra, a third-line treatment based on interleukin-1 inhibition, is safe and efficacious in treating CP and avoiding the requirement for pericardiectomy. This prospective cohort study involved consecutive patients with recurrent or incessant pericarditis with corticosteroid dependence and colchicine resistance. Anakinra 100 mg once daily was subcutaneously administered to enrolled patients. A diagnosis of CP was received by 8/39 (20%) patients during follow-up. Following anakinra dose of 100 mg/day, a complete resolution of pericardial constriction was evident in 5 patients (63%) within a median of 1.2 months. Chronic CP was identified in other three patients (37%), needing pericardiectomy within a median of 2.8 months. Experts suggested a likely role of anakinra in CP reversal among patients with recurrent or incessant pericarditis. The risk of CP was identified to be related to incessant rather than recurrent course.