Table 2.

Proposed updated treatment algorithm for recurrent pericarditis including rilonacept

Pericarditis event	Treatment
Acute pericarditis	- NSAIDs (week(s)) - Colchicine (3 months)
Recurrent pericarditis — first event	- NSAIDs (weeks to months) - Colchicine (≥ 6 months)
Recurrent pericarditis — second event or beyond	- NSAIDs (weeks to months) - Colchicine (≥ 6 months) - Rilonacept can be considered, including ahead of corticosteroids, and other drugs if intolerant
Recurrent pericarditis — colchicine resistance and/or corticosteroid dependent	- NSAIDs - Colchicine - Rilonacept, including while tapering down other agents especially corticosteroids
Recurrent pericarditis — rilonacept failure	- Consider alternative interleukin-1 inhibitor (such as anakinra) - Intensify anti-inflammatory combinations - Pericardiectomy may be considered (last line)