Longitudinal cardiac magnetic resonance imaging following clinical response to rilonacept and prior to recurrence upon treatment suspension: a RHAPSODY subgroup analysis
2024

Cardiac Imaging Study on Rilonacept for Pericarditis

Sample size: 13 publication 10 minutes Evidence: moderate

Author Information

Author(s): Cremer Paul C, Brucato Antonio, Insalaco Antonella, Lin David, Luis Sushil A, Kwon Deborah H, Jellis Christine L, Clair JoAnn, Curtis Allison, Wang Sheldon, Klein Allan L, Imazio Massimo, Paolini John F

Primary Institution: Cleveland Clinic, Heart and Vascular Institute

Hypothesis

Can longitudinal cardiac magnetic resonance imaging predict outcomes after treatment suspension in patients with recurrent pericarditis treated with rilonacept?

Conclusion

Long-term treatment with rilonacept improved clinical outcomes and imaging results, but the absence of late gadolinium enhancement did not predict future recurrences after treatment suspension.

Supporting Evidence

  • Patients who continued rilonacept treatment showed significant clinical improvement.
  • Imaging results indicated reduced pericardial thickness and resolution of edema.
  • 71% of patients who suspended treatment had recurrences within 1-4 months.

Takeaway

This study looked at how heart scans can help doctors decide if patients with a heart condition called pericarditis should keep taking their medicine or stop. It found that even if the scans look good, patients might still have problems later.

Methodology

Patients underwent cardiac magnetic resonance imaging at baseline and after 18 months of treatment to assess changes in pericardial thickness, edema, and late gadolinium enhancement.

Potential Biases

Potential bias due to lack of external adjudication for recurrence events.

Limitations

The study had a small sample size and relied on investigator assessment for recurrence events.

Participant Demographics

{"mean_age":43.1,"female_percentage":53.6,"median_disease_duration":1.6}

Statistical Information

P-Value

p<0.0001

Statistical Significance

p<0.0001

Digital Object Identifier (DOI)

10.1093/ehjci/jeae200

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