Table 1.

Comparison of IL‐1 Antagonists Used in Recurrent Pericarditis in Adults

	Anakinra	Rilonacept	Canakinumab
Ultrastructure	Recombinant protein	Fc fusion protein	IgG monoclonal antibody
IL‐1 α receptor antagonist	+	+	−
IL‐1 β receptor antagonist	+	+	+ (Binds plasma IL‐ β and prevents interaction with receptor)
Half‐life	4 to 6 h	7 d	22 to 26 d
Frequency of administration	Daily	Weekly	Every 4 to 8 wks
Administration route	Subcutaneous intravenous	Subcutaneous	Subcutaneous
Loading dose	−	320 mg	−
Maintenance dose	2 mg/kg (up to 100 mg)	160 mg	4 mg/kg or 150 mg (single dose)
Duration of treatment	6 to 12 months (can extend in patients with recurrences)	9 months with range of   3 to 14 months (can extend in patients with recurrence)	Up to 2 y
Dose adjustment for renal impairment	CrCl ≥30 mL/min: not required CrCl <30 mL/min or ESRD: consider changing dose to every other day. Not dialyzable (<2.5%)	Not required	Not required
Dose adjustment for hepatic impairment	Not required	Not required	Not required
Adverse events	Injection site reactions, hepatitis, infections	Injection site reactions, infections, neutropenia, hyperlipemia	Injection site reactions, infections, neutropenia
Monitoring	CBC, CRP, symptoms/signs of infection, hepatitis B and TB screening at baseline	CBC, CRP, lipid profile, symptoms/signs of infection, hepatitis B and TB screening at baseline	CBC, CRP, symptoms/signs of infections, hepatitis B and TB screening at baseline
Main clinical evidence in pericarditis	AIRTRIP clinical trial International Registry of Anakinra for Pericarditis (IRAP)	RHAPSODY Phase III clinical trial and Phase II study.	Case reports & Case Serie

CBC indicates complete blood count; CrCl, creatinine clearance; CRP, C‐reactive protein; Fc, fragment crystallizable region; IL, interleukin; and TB, tuberculosis.