NSAID: nonsteroidal antiinflammatory drug; IL-1: interleukin-1; CRP: serum C-reactive protein level; ESR: erythrocyte sedimentation rate; CMR: cardiovascular magnetic resonance; CCT: cardiac computed tomography.
* For patients with relative or absolute contraindications to NSAID, a glucocorticoid is an alternative to an NSAID. In addition, it is reasonable to proceed directly to treatment with glucocorticoid plus colchicine if the patient has recently been treated with a course of an NSAID plus colchicine (eg, for treatment of acute or recurrent pericarditis).
¶ For patients with prior recurrent or incessant pericarditis, an IL-1 inhibitor is a reasonable alternative to NSAID plus colchicine or glucocorticoid plus colchicine therapy.
Δ Treatment response is assessed by evaluating symptoms and CRP (with or without repeat imaging). A good response is indicated by improvement or resolution of symptoms, reduction or normalization of the CRP, and, if assessed, improvement or resolution of inflammation on CMR or normalization of pericardial thickness on CCT or CMR.
◊ The IL-1 inhibitor used in this setting may be anakinra or rilonacept.Do you want to add Medilib to your home screen?