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Human intravenous immunoglobulins for recurrent pericarditis: a multicentre cohort study
Valentino Collini1, Francesco Venturelli1,2, Razvan Berghi2
1Cardiology and Cardiothoracic Department, University Hospital Santa Maria della Misericordia, ASUFC, Udine and Department of Medicine, University of Udine, Piazzale Santa Maria della Misericordia 15, 33100 Udine, Italy.
European Journal of Preventive Cardiology
|April 28, 2025
Summary
Intravenous immunoglobulins (IVIG) effectively treated recurrent pericarditis (RP) in patients resistant to other therapies. IVIG significantly reduced recurrence rates and the need for other medications, demonstrating safety and efficacy.
Area of Science:
- Cardiology
- Immunology
- Internal Medicine
Background:
- Recurrent pericarditis (RP) poses a therapeutic challenge, with limited options for refractory cases.
- Intravenous immunoglobulins (IVIG) have been suggested as a potential last-line treatment for RP.
Purpose of the Study:
- To evaluate the efficacy and safety of IVIG in patients with recurrent pericarditis.
- To assess IVIG's effectiveness after failure of conventional medical therapies in a multicentre registry.
Main Methods:
- A multicentre cohort study included consecutive patients with RP treated with IVIG.
- The primary outcome measured was the rate of pericarditis recurrence post-IVIG treatment.
- Patients received IVIG at 400-500 mg/kg/day for 5 days, with potential for repeated cycles.
Main Results:
- 93% of 43 patients achieved clinical remission at discharge.
- Mean annual recurrences decreased from 1.80 to 0.46, and ED admissions from 0.79 to 0.16 (p<0.001).
- IVIG significantly reduced corticosteroid (72.1% to 19.4%) and anakinra use (60.5% to 23.3%).
- No serious adverse events were reported; one patient had reversible neutropenia.
Conclusions:
- IVIG is an efficacious and safe treatment for recurrent pericarditis refractory to conventional therapies.
- IVIG significantly reduces disease recurrence and the need for other medications in resistant RP cases.
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