Individualized therapy for pericarditis

The treatment of pericarditis remains largely empirical owing to a relative lack of randomized, controlled trials; nevertheless, a number of observational studies and the first randomized trials are moving the management of pericardial diseases on the road to evidence-based medicine. Moreover, emerging data suggest that treatment can be tailored to the specific patient and, although the optimal length of treatment is not clearly established, some recommendations can be formulated to guide management and follow-up. Aspirin or a NSAID at medium-to-high dosages are the mainstay of treatment (e.g., aspirin 2-4 g/day, ibuprofen 1200-1800 mg/day, indomethacin 75-150 mg/day). Corticosteroid use should be restricted, and low-to-medium doses (i.e., prednisone 0.2-0.5 mg/kg/day) should be preferred. Colchicine 0.5-1.2 mg/day is effective for reducing recurrences.