Current and Future Treatment for Pericarditis

Acute pericarditis is a common disorder in several clinical settings, and may be the first manifestation of an underlying systemic disease. Disease management is often troublesome and concerns may arise regarding the fear of missing a specific etiology, the possible complications, particularly the evolution toward constrictive pericarditis, and the search for new drugs, following a presumed failure of current treatments. The response is often disproportionate, with extensive repeated diagnostic work-up, frequent readmissions and increasing use of new drugs with a doubtful risk-benefit ratio, often without an evidence-based approach. Frustration and management mistakes are common causes of a prolonged course of the disease and frequent consultations. A vicious circle is thereby maintained and is fostered by the relative lack of clinical trials and evidence-based guidelines. The aim of this paper is to review more recent studies and trials in order to develop a more evidence-based management of the disease.