Although most patients with acute pericarditis will recover, a minority will have recurrent, debilitating episodes. In these patients, refractory symptoms result in high morbidity, and typically require a prolonged duration of anti-inflammatory treatment. Initially, the efficacy of colchicine in both recurrent pericarditis and periodic fever syndromes suggested the central role of the inflammasome in pericarditis. Subsequently, the success of interleukin-1 antagonists in autoinflammatory diseases prompted further investigation in recurrent pericarditis. In current clinical practice, interleukin-1 antagonists include canakinumab, anakinra, and rilonacept. Both anakinra and rilonacept have demonstrated efficacy in randomized trials of patients with recurrent pericarditis. The aim of the current review is to explain the biological rationale for interleukin-1 antagonists in recurrent pericarditis, highlight supporting clinical evidence, and emphasizing future areas of investigation.

尽管大多数急性心包炎患者会康复，但少数患者会反复发作、使人衰弱。在这些患者中，难治性症状导致高发病率，并且通常需要延长持续时间的抗炎治疗。最初，秋水仙碱对复发性心包炎和周期性发热综合征的疗效表明炎性体在心包炎中的核心作用。随后，白细胞介素 1 拮抗剂在自身炎症性疾病中的成功促进了对复发性心包炎的进一步研究。在目前的临床实践中，白介素 1 拮抗剂包括卡那奴单抗、阿那白滞素和利洛西普。阿那白滞素和利洛西普都在复发性心包炎患者的随机试验中证明了疗效。