Positives

• In the RHAPSODY Phase III trial, only 2 of 30 patients on rilonacept had a pericarditis flare versus 23 of 31 on placebo, and many were able to taper steroids PMC.
  
  
• Patients sharing their stories described relief from chest pain and a return to daily activities after starting weekly injections Cleveland Clinic.
  
  

Negatives

• Roughly 34-60% of patients reported transient injection-site reactions, including pain, redness, swelling, itching, and bruising PMC.
  
  
• Patients reported upper respiratory infections, joint and muscle aches, sore throat, and increased risk of serious infections from immune suppression Mayo Clinic.
  
  

Hurdles & Side Effects

• Patients described the weekly self-injection routine and need for refrigeration as a lifestyle adjustment MedlinePlus.
  
  
• Reviewers cited the very high cost (often listed near $20,000/month) and prior-authorization battles as the largest barriers to access Cleveland Clinic.