Clinical Trials in Pericardial Disease: New Paradigm Shift

Purpose of Review Aim of the review is to discuss the results of major clinical trials and how they can have impact on clinical practice. Recent Findings Pericardial diseases have been the Cinderella of cardiovascular diseases for many years, but improvements in the knowledge of etiology and the pathophysiology especially of recurrent pericarditis have led to first clinical trials that have demonstrated the efficacy and safety of colchicine on top of standard anti-inflammatory therapies and of anti-IL-1 agents (anakinra and rilonacept) in corticosteroid-dependent and colchicine-resistant pericarditis. Current pooled data suggest that anti-IL-1 agents should be a first option for corticosteroid-dependent and colchicine-resistant recurrent pericarditis with evidence of systemic inflammation by means of elevated C-reactive protein. This could translate into an upgraded recommendation for these agents in future guidelines. Treatment of pericardial diseases is improving moving towards a more personalized therapy according to the presentation and etiology, and new or old drugs could be important to expand the therapeutic spectrum.

Automated summary

The review discusses recent findings in pericardial diseases, highlighting the potential efficacy of anti-IL-1 agents for corticosteroid-dependent and colchicine-resistant recurrent pericarditis. It suggests that these agents could become a first-line option in future guidelines for cases with systemic inflammation. The treatment of pericardial diseases is gradually becoming more personalized, with consideration of presentation and etiology, and the exploration of new or existing drugs to expand the therapeutic options.