Long-Standing Chronic Recurrent Pericarditis Managed With Advanced Diagnostic and Therapeutic Methods
Muhammad Majid1,2, Akiva Rosenzveig1, Aro Daniela Arockiam1
1Center for Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Robert and Suzanne Tomsich Department of Cardiovascular Medicine, Cleveland Clinic, Cleveland, Ohio, USA.
JACC. Case Reports
|October 3, 2024
Summary
Rilonacept effectively treated chronic recurrent pericarditis when anakinra failed. This interleukin-1 inhibitor therapy reduced inflammation and symptoms, improving patient outcomes.
Area of Science:
- Cardiology
- Immunology
- Inflammatory Diseases
Background:
- Chronic recurrent pericarditis poses a therapeutic challenge.
- Interleukin-1 (IL-1) blockade has emerged as a treatment option for recurrent pericarditis.
- Anakinra, an IL-1 receptor antagonist, may be effective but can be difficult to taper.
Purpose of the Study:
- To evaluate the efficacy of rilonacept in a patient with chronic recurrent pericarditis refractory to anakinra.
- To assess the impact of rilonacept on inflammatory markers and cardiac imaging findings.
Main Methods:
- Case report of a 65-year-old woman with idiopathic recurrent pericarditis.
- Transition of therapy from anakinra to rilonacept due to anakinra intolerance/flares.
- Assessment of symptom response and cardiac magnetic resonance imaging (CMR) before and after rilonacept initiation.
Main Results:
- The patient experienced symptom abatement after transitioning to rilonacept.
- Rilonacept therapy allowed for successful management without recurrent flares.
- Cardiac MRI demonstrated improvement in inflammatory changes following rilonacept treatment.
Conclusions:
- Rilonacept is a viable therapeutic option for chronic recurrent pericarditis, particularly in cases refractory to or intolerant of anakinra.
- IL-1 blockade with rilonacept can lead to clinical improvement and reduction of cardiac inflammation.
- Further studies are warranted to confirm the long-term efficacy and safety of rilonacept in recurrent pericarditis.
Keywords:
IL-1 blockersanakinracardiac magnetic resonance imagingrecurrent pericarditisrilonacepttransthoracic echocardiographyMore Related Videos
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