Home > Riviste > Panminerva Medica > Fascicoli precedenti > Articles online first > Panminerva Medica 2021 Feb 23

ULTIMO FASCICOLO
 

JOURNAL TOOLS

eTOC
Per abbonarsi
Sottometti un articolo
Segnala alla tua biblioteca
 

ARTICLE TOOLS

Publication history
Estratti
Permessi
Per citare questo articolo
Share

 

 

Panminerva Medica 2021 Feb 23

DOI: 10.23736/S0031-0808.21.04210-5

Copyright © 2021 EDIZIONI MINERVA MEDICA

lingua: Inglese

Recurrent pericarditis: an update on diagnosis and management

Alessandra VECCHIÈ 1 , Megan DELL 2, James MBUALUNGU 1, Ai-Chen HO 3, Benjamin Van TASSELL 3, Antonio ABBATE 1

1 Pauley Heart Center, Virginia Commonwealth University, Richmond, VA, USA; 2 Virginia College of Osteopathic Medicine, Carolinas Campus, Spartanburg, SC, USA; 3 Department of Pharmacotherapy and Outcome Sciences, Virginia Commonwealth University, Richmond, VA USA


PDF


Acute pericarditis is a disease of the pericardium characterized by inflammation. Around 16-38% of patients develop recurrent events after the first episode. Recurrent pericarditis (RP) seems to be caused by a pathologic immune response. An inadequate treatment in terms of drug choice, dose, duration of therapy or tapering, has been shown to increase the risk of recurrences. Symptoms, physical signs and electrocardiographic signs are usually less severe during a recurrent event as compared to the first episode, thus favoring imaging as a tool to confirm the diagnosis of RP. Cardiac magnetic resonance is becoming the technique of choice because of its ability to detect active pericardial inflammation. Inflammatory biomarkers can be used to assess the risk of recurrences and to guide the tapering of treatments. First-line treatment is based on non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine. NSAIDs are useful for pain control, and colchicine has shown to reduce the risk of further recurrences. Glucocorticoids are often used as second-line drugs, but they are associated with a high rate of recurrent events. Interleukin-1 inhibitors, such as anakinra and rilonacept, significantly reduce the risk of recurrences in patients with RP while on treatment.


KEY WORDS: Recurrent pericarditis; Diagnosis; Management; IL-1 inhibitors; Anakinra; Rilonacept

inizio pagina