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- Title
Role of immunosuppressive therapy in the management refractory postprocedural pericarditis.
- Authors
Narasimhan, Bharat; Turagam, Mohit K.; Garg, Jalaj; Della Rocca, Domenico G.; Gopinathannair, Rakesh; Biase, Luigi Di; Romero, Jorge; Mohanty, Sanghamitra; Natale, Andrea; Lakkireddy, Dhanunjaya
- Abstract
Objective: To assess the safety and efficacy of a novel immunosuppressive regimen—combination Methotrexate/Prednisone (cMtx/P)—in the management of severe refractory rPPP. Methods: In this multicenter, nonrandomized, retrospective, observational study, 408 consecutive patients diagnosed with persistent rPPP between 2017 and 19 were included. Patients with refractory symptoms despite 3 months of conventional therapy were initiated on a 4‐week regimen of oral steroids. Persistence of symptoms at this point, that is, rPPP (n = 25; catheter based = 18, open surgical = 7) prompted therapy with Methotrexate (7.5–15 mg weekly) with folate supplementation along with low dose prednisone (5 mg PO) for a further 3 months. Patients were followed for a total of 11.3 ± 1.8 months. Results: Treatment refractory rPPP occurred in 6.1% of the study population prompting immunosuppressive therapy with cMtx/P. All patients demonstrated complete symptom resolution following 3 months of treatment with an 85% decline in clinically significant pericardial effusions. One patient developed recurrent pericarditis during the 11‐month follow‐up. Therapy was well tolerated with no significant drug related adverse effects. Conclusion: cMtx/P therapy is a safe and effective adjunct in the management of rPPP refractory to standard therapy.
- Subjects
RESEARCH; PERICARDITIS; COMBINATION drug therapy; SCIENTIFIC observation; IMMUNOSUPPRESSION; MEDICAL cooperation; RETROSPECTIVE studies; METHOTREXATE; DESCRIPTIVE statistics; PREDNISONE; PATIENT safety; PHARMACODYNAMICS
- Publication
Journal of Cardiovascular Electrophysiology, 2021, Vol 32, Issue 8, p2165
- ISSN
1045-3873
- Publication type
Article
- DOI
10.1111/jce.15069