First Cardiology Department, School of Medicine, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, 11527, Greece.
Drug Des Devel Ther. 2024 Sep 4;18:3939-3950. doi: 10.2147/DDDT.S261119. eCollection 2024.
Recurrent pericarditis (RP) has been traditionally regarded as a "nightmare" for both clinicians and patients. Until approximately a decade ago, available treatments were thin on the ground with non-steroidal anti-inflammatory medications, glucocorticoids, colchicine, and classical immunosuppressants being the only options. The first important step in the tale of RP was the advent of colchicine in clinical practice, which has been shown to halve the rate of first and subsequent pericarditis recurrences. The second major breakthrough advance in this setting was the introduction of interleukin-1 inhibitors based on the recently unveiled autoinflammatory nature of pericarditis. At present, anti-interleukin-1 inhibitors available for clinical use in patients with refractory RP include anakinra and rilonacept, with the latter having obtained FDA approval for this indication. Apart from the remarkable efficacy and good safety profile which is a common feature of all anti-interleukin-1 compounds, rilonacept has the advantage of weekly administration (instead of daily compared to anakinra) which is important in terms of adherence to treatment and improved quality of life albeit at the expense of a higher cost. This review aims to summarize the available evidence on the role of rilonacept in the treatment of RP and the reduction of the recurrences risk.
复发性心包炎（RP）一直被临床医生和患者视为“噩梦”。大约十年前，可用的治疗方法很少，只有非甾体抗炎药、糖皮质激素、秋水仙碱和经典免疫抑制剂可供选择。RP 故事中的第一个重要步骤是秋水仙碱在临床实践中的应用，它已被证明可以将首次和随后的心包炎复发率减半。在这种情况下，第二个主要突破进展是基于心包炎的自身炎症性质引入白细胞介素-1 抑制剂。目前，可用于治疗难治性 RP 患者的抗白细胞介素-1 抑制剂包括阿那白滞素和利纳西普特，后者已获得 FDA 对此适应症的批准。除了所有抗白细胞介素-1 化合物的显著疗效和良好的安全性特征外，利纳西普特的优势在于每周给药（与阿那白滞素相比每天给药），这对于治疗依从性和提高生活质量很重要，尽管代价是更高的成本。本综述旨在总结利纳西普特在治疗 RP 和降低复发风险方面的现有证据。
