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Paradigm Shift in Diagnosis and Targeted Therapy in Recurrent Pericarditis

  • Pericardial Disease (AL Klein and CL Jellis, Section Editors)
  • Published:
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A Correction to this article was published on 04 August 2023

This article has been updated

Abstract

Purpose of the Review

We review the pathophysiology, diagnosis, and contemporary treatment for recurrent pericarditis, with focus on interleukin-1 (IL-1) inhibitors.

Recent Findings

Recurrent pericarditis occurs in about 15–30% of patients who have acute pericarditis. With increased understanding of the autoinflammatory pathophysiology of recurrent pericarditis, IL-1 inhibitors including anakinra, canakinumab, and rilonacept have been applied to this condition with great promise. In particular, the RHAPSODY trial found rilonacept significantly improves pain and inflammation, while also reducing recurrence with few adverse events. The next IL-1 inhibitor on the block for pericarditis, goflikicept, is also discussed.

Summary

Understanding the role of the inflammasome via the autoinflammatory pathway in pericarditis has led to incorporation of IL-1 inhibitors in the treatment of recurrent pericarditis, with proven efficacy and safety and randomized trials. This will lead to increase uptake of this agent which demonstrated lower rates of recurrence and faster time to resolution.

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Data Availability

Data sharing is not applicable to this article as no new data were created or analyzed in this study.

Change history

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Acknowledgements

This study received no specific grant from any funding agency in the public, commercial, or not-for-profit sectors. Dr AL Klein has received research funding from Kiniksa Pharmaceuticals, Ltd; and have served on scientific advisory boards for Kiniksa Pharmaceuticals, Ltd., Cardiol Therapeutics, and Pfizer, Inc. The other authors have no affiliations with or involvement in any organization or entity with any financial interest, or non-financial interest (such as personal or professional relationships, affiliations, knowledge, or beliefs) in the subject matter or materials discussed in this manuscript.

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Authors and Affiliations

  1. Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine, Heart, Vascular and Thoracic Institute, Cleveland Clinic, 9500 Euclid Avenue, Cleveland Clinic Main Campus, Cleveland, OH, USA

    Tiffany Dong, Allan L. Klein & Tom Kai Ming Wang

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Correspondence to Tom Kai Ming Wang.

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Dong, T., Klein, A.L. & Wang, T.K.M. Paradigm Shift in Diagnosis and Targeted Therapy in Recurrent Pericarditis. Curr Cardiol Rep 25, 993–1000 (2023). https://doi.org/10.1007/s11886-023-01912-8

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