Treat acute or recurrent pericarditis with anti-inflammatory drugs before considering newer treatments

Pericarditis is an inflammatory disease that affects the pericardial sac surrounding the heart. Although usually benign, recurrence is a common complication, and pericarditis may lead to cardiac tamponade or constrictive pericarditis. Non-steroidal anti-inflammatory drugs, with adjunctive colchicine, are the cornerstone of pericarditis treatment. Glucocorticoids should be used with caution. Interleukin-1 blockers anakinra and rilonacept have demonstrated efficacy in reducing pericarditis recurrence rates. Ongoing trials with alternative treatments (e.g. goflikicept, cannabidiol) are showing promise, and new treatment options should be supported by further investigation of pericarditis pathophysiology.