Pericarditis patients with constrictive pericarditis on rilonacept had similar flare rates but higher CP hospitalizations and pericardiectomy than those without CP.
Does rilonacept have similar effectiveness in preventing flares, hospitalizations, and pericardiectomy in pericarditis patients with versus without concomitant constrictive pericarditis?
While rilonacept limits pericarditis flares similarly in patients with and without constrictive pericarditis, those with constriction still face significantly higher rates of heart failure hospitalization and need for pericardiectomy.
Absolute Event Rate: 0% vs 0%
Abstract Background Interleukin-1 blockers including rilonacept have become established second-line agents with for treating recurrent pericarditis, however their utility and effectiveness in those with concomitant constrictive pericarditis (CP) remains unknown. We evaluated the characteristics and outcomes of pericarditis patients on rilonacept with and without CP. Methods Consecutive pericarditis patients with concomitant CP (CP+ group, n=21) when starting on rilonacept during 2022-2024 were compared with pericarditis controls without CP when starting on rilonacept (CP- group, n=21) using standard statistical analyses. The outcomes of interest include pericarditis flares during follow-up, CP heart failure hospitalizations and pericardiectomy surgery during mean follow-up of 1.6±1.1 years. Results Key characteristics of the CP+ and CP- negative groups are summarized in the Table, with signs of constriction in 15 (71%) on echocardiography and 17 (81%) on MRI. The Figure illustrates Kaplan-Meier survival curves of time-to-outcomes of interest. CP+ group had similar incidence of pericarditis flares but significantly higher incidence of CP hospitalizations and pericardiectomy than CP- patients when treated with rilonacept. Conclusion Management of CP+ patients continues to be challenging, when rilonacept can be trialed to limit pericarditis flares, however pericardiectomy remains warranted in the majority. Further research is necessary to determine the optimal treatment strategy for CP+ pericarditis patients.
Wang et al. (Sat,) reported a other. Pericarditis patients with constrictive pericarditis on rilonacept had similar flare rates but higher CP hospitalizations and pericardiectomy than those without CP.