Corticosteroids and immunosuppressive agents for idiopathic recurrent pericarditis.

Abstract:

:Recurrent pericarditis is a frequent and troublesome complication of acute pericarditis. Aspirin or non-steroidal anti-inflammatory drugs (NSAIDs) and colchicine are the mainstay of therapy but few data is available on second-line treatment. We retrospectively analyzed 13 patients, 7 females (54%), median age 40 years, with a median of 4 (IQR 1-6) recurrences per patient despite a well conducted first-line treatment and a median follow-up of 59 months (IQR 38-70). Ten patients received corticosteroids as second-line therapy; 6 out of 10 responded to this therapy while 4 needed the addition of azathioprine. Three other patients received an immunosuppressive agent as second-line therapy (azathioprine, methotrexate, mycophenolate mofetyl). Overall, the mean frequency per month (± SD) of pericarditis recurrences was 0.69 (± 0.40) with aspirin/NSAIDs and colchicine, 0.22 (± 0.34) with corticosteroids alone and 0.01 (± 0.04) with immunosuppressive agents (p < 10-4). Immunosuppressive agents including azathioprine, methotrexate and mycophenolate mofetyl seem efficacious and well tolerated in patients with idiopathic recurrent pericarditis unresponsive to corticosteroids, corticosteroids-dependent or when corticosteroids side effects are judged unacceptable.

journal_name

Autoimmun Rev

journal_title

Autoimmunity reviews

authors

Peiffer-Smadja N,Domont F,Saadoun D,Cacoub P

doi

10.1016/j.autrev.2019.04.001

subject

Has Abstract

pub_date

2019-06-01 00:00:00

pages

621-626

issue

6

eissn

1568-9972

issn

1873-0183

pii

S1568-9972(19)30091-6

journal_volume

18

pub_type

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