Optimizing recurrent pericarditis management through IL-1 inhibition and the evolving multidisciplinary pharmacist-led care to comprehensive patient management

Recurrent pericarditis is a relapsing inflammatory disorder driven by overlapping autoimmune and autoinflammatory mechanisms, with interleukin-1 (IL-1) playing a central role in disease pathogenesis. Although first-line treatment with nonsteroidal anti-inflammatory drugs and colchicine, with the use of corticosteroids when necessary, effectively controls disease in most patients, a subset remains refractory or corticosteroid-dependent, experiencing frequent relapses despite optimal conventional therapy. Biologic agents targeting IL-1 in clinical applications, including anakinra and rilonacept, have demonstrated rapid symptom relief, reduced recurrence rates, decreased corticosteroid exposure, and favorable safety profiles, particularly in patients with elevated inflammatory markers and clinical features consistent with an autoinflammatory phenotype. Pharmacists are well positioned to address these gaps through medication review, patient education, interaction screening for biologics, vaccination counseling, and reinforcement of exercise restriction. Therefore, integrating pharmacists into multidisciplinary pericarditis care pathways can improve clinical outcomes, reduce recurrence rates, and enhance overall quality of life. This review provides an extensive overview of the current evidence supporting the use of IL-1 inhibitors in the treatment of recurrent pericarditis and explores the expanding role of pharmacists within multidisciplinary care teams. It also emphasizes strategies to optimize pharmacotherapy, reduce reliance on corticosteroids, enhance medication adherence and safety, and ultimately decrease the risk of disease recurrence.