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Prednisone in the Management of Pericarditis A Systematic Review
Ghazal Razeghi1, Faisal Ahmed2, Alfred E Genadri2
1Department of Medicine, University of Ottawa, Ottawa, Ontario, Canada.
Journal of Cardiovascular Pharmacology
|August 4, 2026
Summary
Oral corticosteroids are frequently used for pericarditis, but evidence on their effectiveness and recurrence risk is inconsistent. More high-quality trials are needed to guide optimal corticosteroid use in pericarditis.
Area of Science:
- Cardiology
- Pharmacology
Background:
- Corticosteroids are commonly prescribed for pericarditis, often deviating from guidelines.
- Existing observational data show conflicting results regarding corticosteroid use and pericarditis recurrence.
- Optimal dosing and tapering strategies for corticosteroids in pericarditis remain undefined.
Purpose of the Study:
- To systematically review oral corticosteroid use in acute or recurrent pericarditis.
- To characterize treatment patterns and assess the association between corticosteroids and pericarditis recurrence.
Main Methods:
- Systematic review of MEDLINE, EMBASE, CENTRAL, and Scopus databases up to November 26, 2025.
- Inclusion of randomized trials, cohort studies, and case-control studies of adults with pericarditis treated with oral corticosteroids.
- Descriptive synthesis of data due to heterogeneity; risk of bias assessed using Newcastle-Ottawa Scale.
Main Results:
- Ten studies (2 prospective, 8 retrospective) with 2632 patients were included.
- Prednisone was common, but dosing and tapering strategies were highly variable.
- Recurrence associations were inconsistent for acute idiopathic and post-procedure pericarditis; higher recurrence was noted with corticosteroids in recurrent pericarditis.
Conclusions:
- Limited evidence exists due to heterogeneity, confounding, and inconsistent reporting of corticosteroid strategies.
- Observational data suggest variable associations between corticosteroid use and pericarditis recurrence.
- High-quality randomized trials stratified by pericarditis type are necessary to establish optimal corticosteroid use.
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