Rilonacept in Refractory Immune Checkpoint Inhibitor–Induced Recurrent Pericarditis

Immune checkpoint inhibitors (ICIs) have revolutionized cancer treatment but are associated with rare immune-related adverse events, particularly cardiotoxicity. We present the case of a 63-year-old man with a history of metastatic melanoma treated with ipilimumab and nivolumab, who developed recurrent pericarditis complicated by cardiac tamponade on 2 separate occasions with 1 episode resulting in cardiac arrest. Despite ICI disruption and standard pericarditis treatment of a prolonged course of colchicine and prednisone, the patient experienced recurrent pericarditis. The introduction of rilonacept led to significant clinical improvement. This case demonstrates the potential effectiveness of rilonacept in managing ICI-induced recurrent pericarditis, especially when conventional treatment fails.