IL-1 Pathway Inhibition in Recurrent Pericarditis Management: Real-World Adoption of Corticosteroid Sparing in RESONANCE
Authors' conclusion
In RESONANCE, IL-1 pathway inhibition increasingly replaced corticosteroids as second-line therapy. Most patients starting corticosteroids transitioned to IL-1 pathway inhibition; few transitioned from second-line IL-1 pathway inhibition to long-term corticosteroids. These findings may inform treatment algorithms and patient-provider decision-making.
Study context
- Population
- Patients receiving treatment for idiopathic and postprocedural recurrent pericarditis (RP)patients with aspirin/nonsteroidal anti-inflammatory drugs/colchicine treatment
- Participants
- 313 patients
- Exposure
- Temporal trends in corticosteroid-sparing treatment of RP
- Outcome
- Treatment intensification
Methodological detailscombines retrospective and prospective data from clinical practice into a single observation period
- Combines retrospective and prospective data from clinical practice into a single observation period
Main finding
As reported in the abstract
Intensified treatment
44%
n = 138
Observational data: associations, not effects.
Further findings
| Outcome | Before rilonacept approval in RP | After rilonacept approval |
|---|---|---|
| Second-line therapy among patients who intensified | ||
| Corticosteroids | 71% (n = 10) | 33% (n = 14) |
| IL-1 pathway inhibition | 29% (n = 4) | — not stated in the abstract |
| IL-1 pathway inhibition (by 2023) | — not stated in the abstract | 64% (n = 27; rilonacept: 57%, anakinra: 7%) |
— not stated in the abstract
- Second-line therapy among patients who intensified: P = 0.02
Transition of second-line corticosteroid initiators to IL-1 pathway inhibition
- Of second-line corticosteroid initiators, later transitioned to IL-1 pathway inhibition
- ≈59% (n = 35)
Subsequent corticosteroid use for >30 days among patients starting second-line IL-1 pathway inhibition
- Rilonacept starters
- 5% (n = 3, rilonacept)
- Anakinra starters
- 25% (n = 4, anakinra)
Original publication
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