Arcalyst (rilonacept) / Regeneron, Kiniksa Pharmaceuticals, Huadong Medicine - LARVOL DELTA

Rilonacept Reduces Pericarditis Recurrence Risk, Hospitalizations, and ED Visits: Outcomes From the RESONANCE Patient Registry (ACR Convergence 2026) - "In pts failing NSAIDs/Colchicine, 2nd line rilonacept provided superior recurrence rate and disease burden reductions versus 2nd line CS, affirming the evidence-based corticosteroid-sparing paradigm shift recommended by the 2025 ACC CCG."

Clinical • Cardiovascular • Inflammation

Fast-Track IL-1 Inhibition in Recurrent Pericarditis: A Five-Patient Case Series of Anakinra Induction Followed by Rilonacept Maintenance (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular

Recurrent Pericarditis on Long-Term Rilonacept in a Young Woman Desiring Pregnancy: When Biologic Dependence Drives Pericardiectomy (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular

Sustained Exercise Tolerance on Rilonacept in Athletes with Recurrent Pericarditis: A Three-Case Series (AHA 2026) - "Abstract is embargoed at this time."

Clinical • Cardiovascular

Long-Term Suppression of Recurrent Myopericardial Inflammation in Desmoplakin Cardiomyopathy with Rilonacept (AHA 2026) - "Abstract is embargoed at this time."

Cardiomyopathy • Cardiovascular • Inflammation

Early Changes in Lipid Parameters After Rilonacept Initiation (AHA 2026) - "Abstract is embargoed at this time."

Recurrent Post-Cardiac Injury Syndrome Refractory to Rilonacept Requiring Surgical Aortic Valve Replacement & Pericardiectomy (AHA 2026) - "Abstract is embargoed at this time."

Cardiovascular • Heart Failure

Earlier rilonacept use in recurrent pericarditis reduces subsequent recurrence burden and treatment escalation: outcomes from the RESONANCE patient registry (ESC 2026) - "In this multicenter US registry, rilonacept use earlier in the RP disease course (reflected in ACC Concise Guidance) reduced recurrence rates and need for next line therapy; conversely, 2L GC use (consistent with ESC Guidelines) increased recurrence rates and need for next line therapy. High rates of dose intensification, treatment escalation, and suboptimal disease control observed with 1L NSAIDs ± colchicine are also important considerations when evaluating IL-1 pathway inhibition use earlier in the disease course to minimize recurrence burden and streamline long-term disease management."

Clinical • Cardiovascular • IL1B

Targeting IL-1 in SLE-Associated Recurrent Pericarditis: A Case Series and Review of Mechanistic Rationale. (PubMed, J Cardiovasc Pharmacol) - "IL-1 blockade with rilonacept was associated with clinical and imaging improvement and substantially reduced reliance on glucocorticoids and other anti-inflammatory agents in SLE-associated recurrent pericarditis. These findings support IL-1 inhibition as a targeted, steroid-sparing strategy in refractory disease and further prospective investigation."

Journal • Cardiovascular • Immunology • Inflammation • Inflammatory Arthritis • Lupus • Rheumatology • Systemic Lupus Erythematosus • CRP

Recurrent Sterile Pleuropericarditis After Withdrawal of Renal Transplant Immunosuppression in Anuric ESRD: A Case of Suspected IL-1-Mediated Autoinflammation. (PubMed, Case Rep Rheumatol) - "Rilonacept was attempted as an IL-1-targeted alternative because of long-term colchicine toxicity concerns in ESRD; however, exposure was limited, and sustained disease control occurred after resumption of colchicine. This case highlights the need for further study of IL-1 inhibitor use in ESRD patients, a population with limited representation in landmark recurrent pericarditis trials such as RHAPSODY and AIRTRIP."

Journal • Cardiovascular • Chronic Kidney Disease • Glomerulonephritis • IgA Nephropathy • Inflammation • Nephrology • Oncology • Renal Disease • Respiratory Diseases • Transplantation

REPAIR-CS: Rilonacept in Subjects With Cardiac Sarcoidosis (clinicaltrials.gov) - P2 | N=60 | Recruiting | Sponsor: Mayo Clinic | Trial primary completion date: Nov 2026 ➔ Mar 2027

Trial primary completion date • Immunology • Sarcoidosis

Multiyear Recurrent Pericarditis Disease Duration: Clinical Outcomes After Cessation of Long-Term Interleukin-1 Pathway Inhibition Provide Insights for Chronic Management. (PubMed, J Am Heart Assoc) - P3 | "The vast majority (86%) of the patients who experienced an off-treatment recurrence after 28 months of rilonacept restarted interleukin-1 pathway inhibition or corticosteroids, suggesting that NSAIDs/colchicine are insufficient in the management of patients with prolonged advanced disease. Rilonacept cessation and subsequent passive gradual washout is an evidence-based pragmatic approach to determine if continued therapy is warranted to prevent subsequent recurrences."

Clinical data • Journal • Cardiovascular • Inflammation • Pain • CRP • IL1A • IL1B

ARCALYST (IL-1α and IL-1β cytokine trap) (The Manila Times) - "ARCALYST net product revenue was $243.6 million for the second quarter of 2026; As of the end of the second quarter of 2026, approximately 21% of the 14,000 multiple-recurrence patients were actively on ARCALYST treatment; Since launch, more than 5,000 prescribers have written ARCALYST prescriptions for recurrent pericarditis; As of the end of the second quarter of 2026, average total duration of ARCALYST therapy in recurrent pericarditis was approximately 3 years, in line with the median duration of disease."

Commercial • Sales • Immunology • Inflammation

Blocking interleukin-1 in pericarditis: Should we move earlier and stronger? (PubMed, Rev Med Interne) - "Standard first-line therapy combines non-steroidal anti-inflammatory drugs or aspirin with colchicine, which reduces but does not eliminate the risk of recurrence...Anakinra, rilonacept and other IL-1-targeting agents provide rapid symptom resolution and dramatically reduce recurrences, thereby transforming the management of difficult-to-treat forms of the disease. This review summarizes current knowledge on the IL-1 pathway in pericarditis and examines whether earlier, targeted intervention could modify disease trajectory, particularly in patients identified as having a high risk of recurrence at presentation. Drawing parallels with Still's disease, in which early IL-1 inhibition improves long-term outcomes, these data support the need for high-quality trials evaluating IL-1 blockade as a first-line strategy in selected patients with acute pericarditis."

Journal • Cardiovascular • Immunology • Inflammation

Recurrent Pericarditis in a Rugby Player: Imaging-Guided Therapy. (PubMed, JACC Case Rep) - "This case demonstrates the complexity of recurrent pericarditis management in a high-risk athlete despite clinical and CMR improvement. Serial CMR and clinical risk scores may provide supportive, hypothesis-generating context for individualized care and cautious tapering."

Journal • Cardiovascular

Cardioimmunology of Myocarditis: Targeting the IL-1 Pathway. (PubMed, Curr Cardiol Rep) - "Clinically, the randomized trial of anakinra in acute myocarditis (ARAMIS) did not improve outcomes in a largely low-risk cohort, but accumulating case reports and small series suggest potential benefit in fulminant/hyperinflammatory myocarditis and chronic active refractory myocarditis...Key clinical questions remain unresolved, including patient selection, timing of initiation, and treatment duration. Future studies should focus on identifying inflammatory endotypes and evaluating targeted immunomodulatory strategies, including in emerging settings such as ICI-associated myocarditis in which IL‑1 blockade remains investigational."

Journal • Review • Cardiovascular • Immunology • Infectious Disease • Inflammation • Oncology • NLRP3

Management of pericarditis: recent advances. (PubMed, Pol Arch Intern Med) - "For most patients with acute idiopathic or presumed viral pericarditis, aspirin or a non-steroidal anti-inflammatory drug combined with colchicine is first-line therapy, with exercise restriction and follow-up guided by symptoms and C-reactive protein. Randomized and registry data now support IL-1 inhibition (eg, anakinra or rilonacept) for corticosteroid-dependent and colchicine-resistant recurrent pericarditis, allowing rapid symptom control, withdrawal of corticosteroids, and marked reduction in recurrences. Remaining challenges include optimal treatment duration, cost and access to biologics, management of patients without overt systemic inflammation, and personalized strategies for tapering and return to activity."

Journal • Cardiovascular • Inflammation • Pain • CRP

Constrictive-effusive pericarditis as presenting feature of IgG4-related disease (IgG4-RD): a case report. (PubMed, J Med Case Rep) - "This case highlights difficulty in diagnosing and treating IgG4-RD. His initial IgG4 serum level was normal to only mildly elevated. Definitive diagnosis was via tissue biopsy which required open heart surgery to access. Prior to the diagnosis, he was treated with methylprednisolone which led to severely elevated glucose levels. Oral steroids could not stop the progression of constrictive pericarditis. Pericardiectomy and subsequent treatment with rituximab led to continued remission."

Journal • Cardiovascular • Fibrosis • Immunology • Infectious Disease • Inflammation • Pancreatitis • Respiratory Diseases

Pathway for the Diagnosis and Management of Pericardial Disease: Contemporary Perspective. (PubMed, Crit Pathw Cardiol) - "In cases of acute pericarditis, management employs a three-tier escalation approach, with interleukin-1 inhibitors (rilonacept, anakinra) as the preferred escalation for inflammatory phenotypes unresponsive to NSAIDs and colchicine. Constrictive pericarditis is classified into three subtypes: transient/inflammatory, effusive-constrictive, and chronic/fixed, each with a distinct management pathway, reserving surgical pericardiectomy at specialized centers for fibrotic or medically refractory cases. This pathway consolidates current evidence into a reproducible clinical framework designed to standardize care, enhance diagnostic precision, and facilitate shared decision-making among multidisciplinary pericardial disease teams."

Journal • Cardiovascular • Congestive Heart Failure • Fibrosis • Heart Failure • Pain • Pulmonary Disease

A Novel Mutation in a Case of Deficiency of Interleukin-1 Receptor Antagonist in a Filipino Male Child (EAACI 2026) - "Since then, he continued to be managed with acitretin 10 mg daily, as anakinra and rilonacept are unavailable in our country, with methotrexate eventually added at 6 years old. At around this time, he also started having bilateral thigh pain with x-rays documenting lesions suspicious for osteomyelitis, and an x-ray taken when he had right knee pain showed arthritis hence colchicine was also added to his regimen. Conclusion : This case highlights the challenges in diagnosing DIRA—pustulosis was initially attributed to infection and atopic dermatitis, and despite the diagnosis of pustular psoriasis, it took quite some time before a genetic cause was explored. Lack of access in low- and middle-income countries to biological treatment—standard of care in such cases—remains a significant hurdle to optimal management."

Clinical • Atopic Dermatitis • Dermatitis • Immunology • Inflammation • Primary Immunodeficiency • Psoriasis • Pustular Psoriasis • IL1RN

Updates on Pathophysiology of Pericarditis to Guide Development of Therapeutics. (PubMed, Curr Cardiol Rep) - "This evidence supports the central role of the NLRP3 inflammasome/IL-1β axis in driving acute inflammation of the pericardium and subsequent flares, as indirectly highlighted in seminal clinical trials of anakinra (AIRTRIP trial), rilonacept (RHAPSODY trial), and goflikicept. Accordingly, a shift moving from the prescription of glucocorticoids as second-line therapy in favor of IL-1 blockers, particularly in those patients presenting with an auto-inflammatory phenotype, is ongoing. To this end, an imaging-guided approach may help choosing the best treatment and monitoring its effects across time, thus allowing a personalized approach to patients with recurrent pericarditis."

Journal • Review • Cardiovascular • Inflammation • IL1B • NLRP3

Recurrent Pericarditis Evolving to Constrictive Pericarditis and Pericardiectomy Over 18 Years. (PubMed, JACC Case Rep) - "The role and timing of biologic therapy in RP requires further research, while pericardiectomy remains definitive once fibrosis predominates."

Journal • Cardiovascular • Fibrosis • Immunology • Pain • Pulmonary Disease

Leveraging Interleukin-1 Blockade as a Therapeutic Strategy for Cardiac Sarcoidosis: Rationale and Design for the RandomizEd PhAse II TrIal of Rilonacept in Subjects With Cardiac Sarcoidosis (REPAIR-CS). (PubMed, J Card Fail) - P2 | "This review aims to reassess current management strategies for CS and provide a detailed overview of the ongoing randomized, open-label, RandomizEd PhAse II TrIal of Rilonacept in Subjects With Cardiac Sarcoidosis (REPAIR-CS) (NCT06660732), which is investigating the efficacy of rilonacept, an IL-1α and IL-1β cytokine trap, added to standard nonbiologic therapy in patients with CS after 24 weeks of therapy. The study's design and endpoints, including the primary outcome of improvement in myocardial inflammation as measured by fluorodeoxyglucose-positron emission tomography imaging, will be discussed in the context of their potential to inform future treatment guidelines and improve outcomes for patients with this challenging disease."

Journal • P2 data • Review • Cardiomyopathy • Cardiovascular • Congestive Heart Failure • Diabetes • Heart Failure • Hypertension • Immunology • Inflammation • Metabolic Disorders • Sarcoidosis • IL1B

Retraction Note: Real-world data and Mendelian randomization analysis in assessing adverse reactions of rilonacept. (PubMed, Int J Clin Pharm) - No abstract available

Journal • Real-world evidence

Demyelination Reported with Biologic Therapies for Rheumatologic and Inflammatory Bowel Diseases: Insights from FAERS (AAN 2026) - "Mechanistic classes included: anti–tumor necrosis factor (TNF)-α agents, anti-integrin antibodies (excluding natalizumab), anti-interleukin agents (including IL-12/23, IL-23, IL-17, IL-6, and IL-1 inhibitors), B-cell targeted therapies (excluding rituximab), and T-cell co-stimulation modulators...Results Safety signals for demyelination were identified with TNF-α inhibitors (infliximab, adalimumab, certolizumab pegol, golimumab, and etanercept) with a PRR of 7.34 (95% CI: 6.75–7.98), and abatacept, a selective T-cell co-stimulation modulator (PRR: 2.12; 95% CI: 1.41–3.20). No safety signals were observed for IL-12/23 inhibitors (ustekinumab), IL-17 inhibitors (secukinumab, ixekizumab, bimekizumab), IL-23 inhibitors (mirikizumab, guselkumab, tildrakizumab, risankizumab), and anti-α4β7 integrin (vedolizumab). Reporting counts were insufficient for IL-6 inhibitors (tocilizumab and sarilumab), IL-1 inhibitors (anakinra, canakinumab, and rilonacept), and B-lymphocyte..."

Gastroenterology • Gastrointestinal Disorder • Hematological Disorders • Immunology • Inflammation • Inflammatory Bowel Disease • IL12A • IL17A • IL23A