Eli Lilly and Company / Ventyx Biosciences, Inc.

Recurrent pericarditis

40K US cases/yr · $678M ARCALYST (rilonacept) 2025 net product revenue (proxy for treated RP market) · 14,000 US patients with multiple recurrences (target population for biologic therapy)

Disease Overview

Recurrent pericarditis is a chronic autoinflammatory cardiovascular condition characterized by repeated episodes of pericardial inflammation following an index acute pericarditis event. Pericarditis carries an incidence of roughly 27.7 cases per 100,000 population per year, and 15-30% of acute pericarditis patients experience a first recurrence within 18 months despite optimal conventional therapy (NSAIDs, colchicine, corticosteroids). The NLRP3 inflammasome drives IL-1 beta-mediated inflammation of the pericardium, making IL-1 blockade and upstream NLRP3 inhibition central mechanistic targets. Multiply recurrent disease imposes substantial morbidity, steroid dependence, and quality-of-life burden, with few well-tolerated long-term options outside IL-1 blockade.

Competitive Landscape

The recurrent pericarditis competitive landscape is currently anchored by IL-1 blockade. Kiniksa's ARCALYST (rilonacept), an IL-1 alpha/beta cytokine trap, is the only FDA-approved therapy and drove $677.6M in 2025 net revenue with guidance of $900-920M for 2026. Off-label anakinra (IL-1 receptor antagonist; Swedish Orphan Biovitrum/Sobi's Kineret) is used for refractory disease. Goflikicept (R-Pharm's IL-1 alpha/beta inhibitor) is in late-stage development as an alternative IL-1 trap. Upstream NLRP3 inhibition is the next competitive wave: Ventyx's VTX2735 (peripherally restricted NLRP3) is the lead asset entering Phase 2, with Olatec/Novartis' dapansutrile (OLT1177) in earlier development for related inflammatory indications. Differentiation levers in this category are oral vs. injectable administration, frequency of dosing, and ability to taper or eliminate chronic steroids.