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Recurrent pericarditis: new and emerging therapeutic options
Massimo Imazio1, George Lazaros2, Antonio Brucato3
1Cardiology Department, Maria Vittoria Hospital, and Department of Public Health and Pediatrics, University of Torino, Via Luigi Cibrario 72, 10141 Torino, Italy.
Nature Reviews. Cardiology
|August 12, 2015
Summary
Recurrent pericarditis affects 20-50% of patients, often remaining idiopathic but presumed immune-mediated. Treatment involves NSAIDs and colchicine, with corticosteroids and other options for refractory cases.
Area of Science:
- Cardiology
- Immunology
- Internal Medicine
Background:
- Recurrent pericarditis is a frequent complication (20-50%) following initial pericarditis episodes.
- The exact cause is often idiopathic, though immune-mediated mechanisms (autoimmune/autoinflammatory) are suspected.
- Understanding recurrence pathogenesis is crucial for prevention.
Purpose of the Study:
- To review the etiology, diagnosis, and comprehensive treatment strategies for recurrent pericarditis.
- To highlight current therapeutic mainstays and alternative options.
Main Methods:
- Literature review of recurrent pericarditis etiology, diagnosis, and treatment.
- Discussion of pharmacological interventions and their indications.
Main Results:
- First-line therapy includes NSAIDs (nonsteroidal anti-inflammatory drugs) and colchicine.
- Corticosteroids are a second-line option for specific indications or persistent symptoms.
- Alternative treatments like azathioprine, IVIg, and anakinra are available for refractory cases.
Conclusions:
- Effective management of recurrent pericarditis relies on a stepwise therapeutic approach.
- Further research into the underlying pathogenesis is essential for developing preventative strategies.
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