Interleukin-1 has been involved as a mediator of chronic pericarditis. A phase 3 trial of rilonacept was performed in patients with acute symptoms and systemic inflammation. During the run-in period, the median time for pain resolution or near-resolution was 5 days, and the median time for normalization of CRP was 7 days. Injection site reactions and upper respiratory tract infections were the most common adverse events. Among patients with chronic periecarditis, treatment resulted in rapid resolution and a slightly lower risk of recurrence than placebo. The most common side effects were injection site reactions and upper respiratory tract infections.
Phase 3 Trial of Interleukin-1 Trap Rilonacept in Recurrent Pericarditis. https://www.nejm.org/doi/full/10.1056/NEJMoa2027892
Guidelines prescribe that one or more antiarrhythmic medications be tested before catheter ablation is considered in patients with atrial fibrillation. First-line ablation could be more effective in preserving sinus rhythm, we’ve discovered. Severe adverse effects resulted in 5 patients who underwent ablation and 6 patients who prescribed antiarrhythmic drug treatment. Patients undergoing initial care for symptomatic, paroxysmal atrial fibrillation had a slightly lower risk of recurrence with catheter cryoballoon ablation than with antiarrHythmicDrug, as measured by continuous heart rhythm testing. The median ratio of time of atrial fibrillation was 0 per cent (interquartile scale, 0 to 0.08) with ablation and 0.13 per cent with drug treatment compared to 0.60 per cent with ablated therapy.
Cryoablation or Drug Therapy for Initial Treatment of Atrial Fibrillation. https://www.nejm.org/doi/full/10.1056/NEJMoa2029980