Advances in medical therapy for pericardial diseases

ABSTRACT

Introduction: Medical therapy of pericardial diseases is moving forward to the road of evidence-based medicine and has improved in the last years because of the first randomized clinical trials in the area as well as new therapeutic options for recurrent pericarditis.

Areas covered: The present review will focus on more recent advances with a special emphasis on the treatment of pericarditis, the area with more significant improvements in the last years. Medline/Pubmed Library were systematically screened with two specific key searches: ‘pericarditis AND therapy’ and ‘pericardial effusion AND therapy’. The search was restricted to articles published in the last 5 years, in order to select the latest novelties in medical treatment and was restricted to ‘human’ studies and papers in English.

Expert commentary: The anti-inflammatory therapy of pericarditis has been now well defined with first-line agents represented by nonsteroidal anti-inflammatory drugs plus colchicine, low-dose corticosteroids with slow tapering as second-line agents and for specific indications (e.g. specific systemic inflammatory diseases, renal failure, pregnancy, patients with interfering therapies such as oral anticoagulants), and third-line options in case of multiple recurrences (e.g. azathioprine, intravenous immunoglobulins, and especially anakinra).

KEYWORDS:

• Pericarditis
• therapy
• colchicine
• non-steroidal anti-inflammatory drugs
• corticosteroids
• anakinra

Declaration of interest

M Imazio has received institutional research grants from Acarpia and SOBI. The authors have no other relevant affiliations or financial involvement with any organization or entity with a financial interest in or financial conflict with the subject matter or materials discussed in the manuscript apart from those disclosed.

Reviewer Disclosures

Peer reviewers on this manuscript have no relevant financial relationships or otherwise to disclose.

Additional information

Funding

This paper was not funded.