Comparative analysis of recurrence rates following various cessation strategies for rilonacept in recurrent pericarditis
Authors' conclusion
Long-term Rl therapy beyond 18-24 months leads to sustained disease remission in RP, and therapy withdrawal is associated with a recurrence in two-thirds of patients. A strategy that involves a gradual taper of RI therapy appears to be associated with a relatively lower risk of disease recurrence compared with discontinuation without tapering. Larger-scale, multicentre studies with extended follow-up periods are warranted to elucidate optimal treatment durations and to establish standardised cessation protocols.
Study context
- Population
- Adults with recurrent pericarditis (RP) refractory to first-line therapies, receiving Rl for at least 12 months with improvement in symptoms and late gadolinium enhancement on cardiac MRI61.8% female, mean age 54.6±14.17 y
- Participants
- 53 adults
- Exposure
- Abrupt Rl discontinuation versus slow taper
- Abrupt cessation armn = 34
- Taper armn = 19
- Outcome
- Recurrence of RP
Methodological detailssingle centre (pericardial disease centre at Cleveland Clinic, Ohio)
- Single centre (pericardial disease centre at Cleveland Clinic, Ohio)
Main finding
As reported in the abstract
P = 0.042
Observational data: associations, not effects.
Further findings
Time to flare with colchicine post-completion of Rl therapy
- Colchicine associated with delaying the average time to flare by
- 60.7 weeks
Resumption of Rl after a recurrence
- Patients who resumed Rl after a recurrence
- 80%
Original publication
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