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Rilonacept for the treatment of recurrent pericarditis
Agostina M Fava1, Reza Reyaldeen1, Saberio Lo Presti1
1Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular, and Thoracic Institute, Cleveland Clinic, Cleveland, OH, USA.
Expert Opinion on Biological Therapy
|November 10, 2021
Summary
Rilonacept effectively treats recurrent pericarditis by blocking interleukin-1 signaling. This therapy offers rapid symptom relief, reduces recurrence, and allows for glucocorticoid-free treatment options.
Area of Science:
- Cardiology
- Immunology
- Pharmacology
Background:
- Recurrent pericarditis (RP) is an autoinflammatory condition driven by interleukin-1 (IL-1).
- Rilonacept, an IL-1 inhibitor, is a novel therapeutic for RP.
- Rilonacept has received approval for RP treatment following clinical trials.
Purpose of the Study:
- To review clinical trials on rilonacept's efficacy and safety in treating RP.
- To evaluate rilonacept as a treatment for colchicine-resistant or glucocorticoid-dependent RP.
Main Methods:
- Review of Phase 2 and 3 clinical trials.
- Assessment of efficacy, safety, and clinical response to rilonacept.
Main Results:
- Rilonacept demonstrated rapid symptom resolution (median 5 days) and CRP normalization (median 7 days).
- Effective glucocorticoid weaning and reduced recurrence rates compared to placebo were observed.
- Rilonacept showed a favorable safety profile, with common adverse events including injection-site reactions and upper respiratory infections.
Conclusions:
- Rilonacept is a promising therapy for refractory RP, enabling glucocorticoid-free regimens.
- The drug offers rapid clinical response and reduced recurrence.
- Further trials are needed to optimize treatment duration and explore monotherapy potential.
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