The interleukin (IL)-1 antagonist rilonacept is approved by the FDA to treat recurrent pericarditis. In adults and adolescents with multiple recurrences of pericarditis, compared with placebo, rilonacept is associated with a lower risk of recurrent pericarditis, more persistent clinical response, normalized C-reactive protein within 7 days, and a higher number of days with no or minimal pericarditis symptoms. Patients receiving rilonacept could be weaned off of standard therapies for recurrent pericarditis and eventually be transitioned to rilonacept monotherapy. The most common adverse reactions to rilonacept include injection-site reactions, upper respiratory tract infections, and increased lipids. A loading dose of rilonacept is administered subcutaneously (SQ), along with weekly SQ maintenance dosing, which can be self-administered. Rilonacept is indicated for the treatment of recurrent pericarditis and reduction in risk of recurrence in patients age 12 years and older who have an elevated C-reactive protein level and significant disease burden.
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