Treatment with aspirin, NSAID, corticosteroids, and colchicine in acute and recurrent pericarditis.
Empiric anti-inflammatory therapy for acute and recurrent pericarditis is warranted for viral and idiopathic cases that represent most cases of pericarditis in developed countries. For specific uncomplicated etiologies, such as systemic autoimmune diseases and postpericardiotomy syndromes, the same drugs are also indicated. Aspirin and non-steroidal anti-inflammatory drugs (NSAID) are mainstay of therapy with the possible adjunct of colchicine, especially for recurrences. Corticosteroids are a second choice for difficult cases requiring multi-drug therapies and specific medical conditions (i.e., specific cases with systemic autoimmune diseases, postpericardiotomy syndrome, and pregnancy). Medical therapy of pericarditis should be individualized as much as possible providing the attack dose every 8 h to ensure full daily control of symptoms and till remission and C-reactive protein normalization, and then tapering should be considered. The present paper will review current evidence for the treatment of acute and recurrent pericarditis with aspirin, NSAID, corticosteroids, and colchicine.
Cardiology Department, Maria Vittoria Hospital, ASLTO2, Via Luigi Cibrario 72, Torino, 10141, Italy. massimo_imazio@yahoo.it
Massimo
M
Imazio
Yehuda
Y
Adler
D000208:Acute Disease; D000305:Adrenal Cortex Hormones / Q000008:administration & dosage*; D000894:Anti-Inflammatory Agents, Non-Steroidal / Q000008:administration & dosage*; D001241:Aspirin / Q000008:administration & dosage*; D002097:C-Reactive Protein / Q000032:analysis; D003078:Colchicine / Q000008:administration & dosage*; D019468:Disease Management; D054796:Drug Dosage Calculations; D006801:Humans; D010493:Pericarditis / Q000097:blood / Q000188:drug therapy* / Q000209:etiology / Q000503:physiopathology; D011185:Postpericardiotomy Syndrome / Q000188:drug therapy*; D016032:Randomized Controlled Trials as Topic; D055502:Secondary Prevention; D050257:Tubulin Modulators / Q000008:administration & dosage
D000305:Adrenal Cortex Hormones; D000894:Anti-Inflammatory Agents, Non-Steroidal; D050257:Tubulin Modulators; D002097:C-Reactive Protein; D001241:Aspirin; D003078:Colchicine