{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,10]],"date-time":"2026-09-10T04:08:55Z","timestamp":1789013335512,"version":"build-2803163510"},"reference-count":30,"publisher":"Ovid Technologies (Wolters Kluwer Health)","issue":"15","content-domain":{"domain":["www.ahajournals.org"],"crossmark-restriction":true},"short-container-title":["JAHA"],"published-print":{"date-parts":[[2026,8,4]]},"abstract":"<jats:sec xml:lang=\"en\">\n                    <jats:title>Background<\/jats:title>\n                    <jats:p xml:lang=\"en\">Recurrent pericarditis is an interleukin\u20101\u2013mediated chronic autoinflammatory disease. The phase 3 study RHAPSODY (Rilonacept Inhibition of IL\u20101 Alpha and IL\u20101 Beta for Recurrent Pericarditis: a Pivotal Symptomatology and Outcomes Study; NCT03737110) and long\u2010term extension demonstrated that rilonacept reduced the risk of recurrence. After 3\u2009years of rilonacept treatment in RHAPSODY, Italian patients returned to standard management, as rilonacept was not commercially available.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p xml:lang=\"en\">Clinical records from Italian RHAPSODY patients were retrospectively reviewed for the 18\u2010month period post\u2013long\u2010term extension completion to assess recurrent pericarditis disease persistence and time to recurrence after rilonacept cessation\/washout. The primary outcome was pericarditis recurrence (ie, pericarditis pain plus C\u2010reactive protein elevation). Safety was also assessed.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Results<\/jats:title>\n                    <jats:p xml:lang=\"en\">Seventeen patients were included in this analysis. The median disease duration (from incident episode to long\u2010term extension completion) was 48 (interquartile range, 41\u201356) months; the median duration of continuous rilonacept treatment was 28 (interquartile range, 27\u201330) months. Fourteen (82%) of 17 patients experienced a post\u2010trial off\u2010treatment recurrence; the remaining patients (n=3) had no pericarditis recurrences and remained offtreatment. The median time to recurrence (n=14) was 8.0 (interquartile range, 6.0\u20139.0\u2009weeks). Most patients\u2019 (n=8) post\u2010trial off\u2010treatment recurrences were managed with interleukin\u20101 pathway inhibition. Some (n=4) were managed with glucocorticoids, and few (n=2) were managed with NSAIDs\/colchicine. No serious adverse events were experienced.<\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec xml:lang=\"en\">\n                    <jats:title>Conclusions<\/jats:title>\n                    <jats:p xml:lang=\"en\">The vast majority\u00a0(86%) of the patients who experienced an off\u2010treatment recurrence after 28\u2009months of rilonacept restarted interleukin\u20101 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\u2010based pragmatic approach to determine if continued therapy is warranted to prevent subsequent recurrences.<\/jats:p>\n                  <\/jats:sec>","DOI":"10.1161\/jaha.125.044021","type":"journal-article","created":{"date-parts":[[2026,7,28]],"date-time":"2026-07-28T11:47:35Z","timestamp":1785239255000},"update-policy":"https:\/\/doi.org\/10.1161\/crossmarkpolicy","source":"Crossref","is-referenced-by-count":1,"title":["Multiyear Recurrent Pericarditis Disease Duration: Clinical Outcomes After Cessation of Long\u2010Term Interleukin\u20101 Pathway Inhibition Provide Insights for Chronic Management"],"prefix":"10.1161","volume":"15","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-4130-5519","authenticated-orcid":false,"given":"Lucia","family":"Trotta","sequence":"first","affiliation":[{"name":"Ospedale Fatebenefratelli","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-5722-0245","authenticated-orcid":false,"given":"Massimo","family":"Imazio","sequence":"additional","affiliation":[{"name":"University of Udine and Cardiothoracic Department, University Hospital Santa Maria della Misericordia","place":["Udine, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-8560-5866","authenticated-orcid":false,"given":"Emanuele","family":"Bizzi","sequence":"additional","affiliation":[{"name":"Ospedale Fatebenefratelli","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Massimo","family":"Pancrazi","sequence":"additional","affiliation":[{"name":"Ospedale Fatebenefratelli","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1203-000X","authenticated-orcid":false,"given":"Alessandro","family":"Andreis","sequence":"additional","affiliation":[{"name":"Citt\u00e0 della Salute e della Scienza di Torino University Hospital","place":["Turin, Italy"]},{"name":"University of Torino","place":["Turin, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-1443-1840","authenticated-orcid":false,"given":"Antonella","family":"Insalaco","sequence":"additional","affiliation":[{"name":"Ospedale Pediatrico Bambino Ges\u00f9 IRCCS [European Reference Network (ERN) for Rare Immunodeficiency, Autoinflammatory and Autoimmune Diseases (RITA) Center]","place":["Rome, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sheldon","family":"Wang","sequence":"additional","affiliation":[{"name":"Kiniksa Pharmaceuticals","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-0281-1651","authenticated-orcid":false,"given":"JoAnn","family":"Clair","sequence":"additional","affiliation":[{"name":"Kiniksa Pharmaceuticals","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-9240-8369","authenticated-orcid":false,"given":"Allan L.","family":"Klein","sequence":"additional","affiliation":[{"name":"Cleveland Clinic","place":["Cleveland, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7122-9713","authenticated-orcid":false,"given":"Enrico","family":"Tombetti","sequence":"additional","affiliation":[{"name":"Ospedale Fatebenefratelli","place":["Milan, Italy"]},{"name":"Universit\u00e0 di Milano","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-7566-5600","authenticated-orcid":false,"given":"Antonio","family":"Brucato","sequence":"additional","affiliation":[{"name":"Ospedale Fatebenefratelli","place":["Milan, Italy"]},{"name":"Universit\u00e0 di Milano","place":["Milan, Italy"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0001-7622-8851","authenticated-orcid":false,"given":"John F.","family":"Paolini","sequence":"additional","affiliation":[{"name":"Kiniksa Pharmaceuticals","place":["Lexington, USA"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"name":"the RHAPSODY Investigators","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"276","reference":[{"key":"e_1_3_2_2_2","doi-asserted-by":"publisher","DOI":"10.1038\/nrd3800"},{"key":"e_1_3_2_3_2","doi-asserted-by":"publisher","unstructured":"Al\u2010Kazaz M Klein AL Oh JK Crestanello JA Cremer PC Tong MZ Koprivanac M Fuster V El\u2010Hamamsy I Adams DH et\u00a0al. 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