Recurrent pericarditis (RP) is a rare cardiac condition characterized by recurrent inflammation, in which interleukin-1 (IL-1) is a key mediator. Despite increasing use of IL-1 inhibitors, comprehensive evaluations of rilonacept for RP are very limited, especially in China, where RP was newly listed as a rare disease in 2023. This review addresses the current gap by systematically assessing the efficacy, safety, cost-effectiveness, innovativeness, suitability, and accessibility of rilonacept in the management of RP, providing evidence-based guidance for clinical practice. A systematic literature review (PROSPERO registration: CRD42024609978) was conducted across six electronic databases (three international databases, PubMed, Ovid/Embase, The Cochrane Library; three Chinese platforms, CNKI, Wanfang, VIP) from their inception to September 30, 2024. The search protocol incorporated both controlled vocabulary (MeSH terms) and free-text terms specific to rilonacept and RP. Studies were included if they investigated rilonacept for the treatment of RP, and fulfilled all predefined inclusion/exclusion criteria. The retrieved literature underwent comprehensive analysis focusing on efficacy, safety, cost-effectiveness, innovativeness, suitability, and accessibility of rilonacept in RP management. Five clinical studies were identified but no pharmacoeconomic studies were found. All patients experienced a decrease in pericarditis pain to 0.4-0.6 points and a decrease in C-reactive protein levels to 0.22 mg/dL after treatment. The median time to reach therapeutic endpoints was approximately 5-7 days, with significantly reduced recurrence rates and markedly improved quality of life. The treatment demonstrates excellent long-term tolerability. It addresses a critical clinical need, offers convenient administration, and exhibits promising innovation, appropriateness, and accessibility. While its economic feasibility requires post-marketing analysis, the drug shows considerable potential for future clinical application. Rilonacept is effective, tolerable, innovative, and suitable in the treatment of RP, while also showing promise in improving its cost-effectiveness and accessibility. Further comparative and cost-effectiveness studies are needed to fully define the therapeutic role of rilonacept in the RP treatment paradigm.
Zhu et al. (Fri,) studied this question.