Alfredo Cospito, a hunger-striking anarchist with an international following, was denied clemency by Italy’s highest appeals court on Friday.

Cospito, 55, went on hunger strike on Oct. 20 to protest his detention under the “41 bis” isolation regime, which is typically reserved for top Mafia figures.

“Assassins! Assassins!,” a group of the anarchist’s supporters shouted in front of the Italian Corte di Cassazione building in Rome after the ruling was issued.

The Cospito affair has featured prominently in Italian media over recent weeks, and inspired anarchist protests and attacks against Italian targets around the world.

The “41 bis” is designed to prevent jailed organised crime leaders from communicating with outside affiliates, mostly by restricting their contacts with other inmates and visitors.

The regime also entails limits on the time inmates can spend outdoors, censorship over correspondence, and constant surveillance.

Prime Minister Giorgia Meloni’s right-wing government has taken a hard line on the Cospito case, even amid warnings that the hunger strike was putting his life at risk.

In the past three weeks the anarchist has been moved from a remote prison in Sardinia to one with better health facilities in Milan, and then, on Feb. 11, to a hospital.

Cospito, who weighed more than 120 kg before starting his protest, lost more than 40 kg and is surviving on a mix of water and various supplements.

He was placed under the “41 bis” regime in May, under a previous government, after writing articles from prison calling on fellow anarchists to continue their armed struggle.

He is serving time for a non-fatal shooting of a nuclear energy manager in 2012 and a bomb attack on a police academy in 2016, which caused no injuries.

Cospito has been sentenced to 30 years’ imprisonment, but prosecutors have appealed for it to be extended to a life term with no possibility of parole.