Biomarkers and Personalized Medicine in Cardiovascular Disease Symposium

RILONACEPT REDUCES PERICARDITIS RECURRENCE RISK, HOSPITALIZATIONS, AND ED VISITS: OUTCOMES FROM THE RESONANCE PATIENT REGISTRY

Paul C. Cremer, MD¹, Michael S. Garshick, MD^2,3, Sushil A. Luis, MBBS, PhD⁴,  Ajit Raisinghani, MD⁵, Brittany Weber, MD, PhD⁶,  MohamedAl-Kazaz, MD¹, Tracy Hagerty, MD⁷, John J. Ryan, MD⁸, Jonathan R. Salik, MD⁹, Taylor Corey¹⁰, Vidhya Parameswaran, MPH¹⁰, Allan L. Klein, MD¹¹, John F. Paolini, MD, PhD¹⁰, on behalf of the RESONANCE Study Group.

Presenter: Corina Grancorvitz¹⁰

*Corresponding author:

Vidhya Parameswaran, MPH

Kiniksa Pharmaceuticals

100 Hayden Ave. Lexington, MA 02421

+1 7814319100

vparameswaran@kiniksa.com

¹Bluhm Cardiovascular Institute, Northwestern University Feinberg School of Medicine, Chicago, IL, USA

²Cardio-Rheumatology Program, Center for the Prevention of Cardiovascular Disease, NYU Langone Health, New York, NY, USA

³Leon H. Charney Division of Cardiology, Department of Medicine, New York University School of Medicine, New York, NY, USA

⁴Department of Cardiovascular Medicine, Mayo Clinic, Rochester, MN, USA

⁵Division of Cardiology, Department of Medicine, Sulpizio Cardiovascular Center, University of California San Diego, San Diego, California, USA

⁶Division of Cardiovascular Medicine, Department of Medicine, Brigham and Women‘s Hospital, Harvard Medical School, Boston, MA, USA

⁷University of Vermont Medical Center, Burlington, Vermont, USA

⁸University of Utah Hospital, Salt Lake City, Utah, USA

⁹Cardiology Division, Massachusetts General Hospital, Harvard Medical School, Boston, MA, USA

¹⁰Kiniksa Pharmaceuticals Corp., Lexington, Massachusetts, USA

¹¹Department of Cardiovascular Imaging, Center for the Diagnosis and Treatment of Pericardial Diseases, Heart and Vascular Institute, Cleveland Clinic, Cleveland, Ohio, USA 

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Background: Recurrent pericarditis (RP) is an IL-1-mediated chronic autoinflammatory disease. Based on clinical trial evidence, the 2025 ACC Concise Clinical Guidance (ACC CCG) on RP management elevated IL-1 pathway inhibition to 2^nd line as the preferred option over corticosteroids (CS) after NSAIDs/colchicine.

Methods: Annualized recurrence rate (ARR) and healthcare resource utilization (HCRU) data were extracted by chart review from pts who had 1 yr minimum follow-up in RESONANCE, a multicenter US RP pt registry, and were compared by RP treatment regimen.

Results: As of 15 Aug 2025, of the 154 pts (77% idiopathic; median disease duration: 5.2 yrs; median [IQR] observation: 3.8 [1.4] yrs) analyzed, 59.7% (92/154) intensified treatment from NSAIDs ± colchicine to 2^nd line therapy. 2^nd line rilonacept significantly reduced ARR (0.086) versus prior NSAIDs ± colchicine (1.26), P<0.001, whereas 2^nd line CS significantly increased ARR (3.04) versus prior NSAIDs ± colchicine (1.38), P=0.012; almost all recurrences on CS (94.1%) occurred while tapering. Outcomes from 2^nd line rilonacept were significantly superior to 2^nd line CS in both recurrence risk and HCRU (ARR: 0.086 vs. 3.04, P<0.001; hospitalizations: 0 vs. 14.5, P<0.001; ED visits: 0 vs. 43.4, P<0.001).

Conclusion: Real-world data from RESONANCE demonstrate that second-line IL-1 pathway inhibition with rilonacept provides superior clinical outcomes and reduced hospitalizations/ED visits versus corticosteroid-based management strategies. In pts failing NSAIDs/Colchicine, 2^nd line rilonacept provided superior recurrence rate and disease burden reductions versus 2^nd line CS, affirming the evidence-based corticosteroid-sparing paradigm shift recommended by the 2025 ACC CCG.

Keywords: autoinflammatory disease; interleukin‐1; recurrent pericarditis; rilonacept

Disclosures:P.C. Cremer: grants and consultant fees from Kiniksa Pharmaceuticals, grants and personal fees from Sobi; M. S. Garshick: consultant fees from BMS, Agepha, Kiniksa Pharmaceuticals; S.A. Luis: consultant fees from Kiniksa Pharmaceuticals, Cardiol Therapeutics, and Medtronic; A. Raisinghani: consultant fees from Kiniksa Pharmaceuticals; B. Weber: consultant fees from Kiniksa Pharmaceuticals, Novo Nordisk, Horizon Therapeutics, and BMS; M. Al-Kazaz: research grant support from Kiniksa Pharmaceuticals, Ventyx, and Cardiol Therapeutics; speaking honoraria from Kiniksa Pharmaceuticals, and consulting fees from Edwards Lifesciences; T. Hagerty: no relationships to disclose; J.R. Salik: no relationships to disclose; J.J. Ryan: research funding from Merck, Bayer, Liquidia, Janssen PH, Kiniksa, and served as a consultant for Merck, Liquidia, Janssen PH, United Therapeutics, and Kiniksa; T. Corey: no relationships to disclose; C. Grancorvitz, V. Parameswaran and J.F. Paolini: shareholders and employees of Kiniksa Pharmaceuticals; A.L. Klein: grants and consultant fees from Kiniksa Pharmaceuticals, Cardiol Therapeutics, Ventyx, and Pfizer.