Managing Recurrent Pericarditis: Insights and Treatment Options

Identifying patients at higher risk for recurrent pericarditis involves assessing the initial C-reactive protein (CRP) levels, the time taken for CRP normalization, and the presence of prolonged symptoms such as fever. For managing recurrence, the treatment mirrors that of acute pericarditis, utilizing NSAIDs and colchicine, with an extended colchicine course of up to six months compared to three months for acute episodes. Interleukin-1 blockers offer a promising alternative for patients unresponsive to colchicine or dependent on corticosteroids, particularly due to their steroid-sparing effects. These treatments target the inappropriate activation of the innate immune response associated with recurrent pericarditis post-cardiac injury, characterized by elevated CRP levels. The importance of evaluating CRP is underscored for both diagnosis and treatment implications, particularly to avoid corticosteroids, which can increase recurrence risk. Proper management requires careful monitoring of symptoms and inflammatory markers.