Autoimmune and Autoinflammatory Pericarditis: Definitions and New Treatments

Purpose of the Review The purpose of the review is to analyze the pathogenetic mechanisms that underlie acute pericarditis, with attention to autoimmune and autoinflammatory pericarditis, and, in addition, to review the available therapeutic armamentarium. Recent Findings Several studies have been published on the use of anti-IL-1 drugs in recurrent pericarditis, including anakinra and rilonacept. The latest, the RHAPSODY study, based on the use of rilonacept in recurrent pericarditis, has recently reached phase 3 with promising results in terms of efficacy and safety. Alterations in the function of the inflammasome and the consequent overproduction of IL-1 play a pivotal role in the genesis of autoinflammatory pericarditis. Recent studies added evidence to the importance of anti-IL-1 drugs in the treatment of recurrent pericarditis with raised C-reactive protein. In the era of tailored medicine, anti-IL-1 agents may be very useful in the subset of patients with recurrent pericarditis and a clear inflammatory phenotype.

Automated summary

The purpose of the review is to analyze the pathogenetic mechanisms of acute pericarditis, focusing on autoimmune and autoinflammatory pericarditis, and to review available treatment options. Recent studies have shown the efficacy of anti-IL-1 drugs in recurrent pericarditis, particularly in patients with raised C-reactive protein, suggesting their potential usefulness in tailored medicine for patients with a clear inflammatory phenotype.