From the Research
Recurrent pericarditis typically lasts between 18 to 24 months on average, though individual cases can vary significantly. Episodes of recurrence may continue for several years in some patients, with each acute flare lasting about 1 to 2 weeks if properly treated. The duration is influenced by several factors including the underlying cause, treatment approach, and individual patient characteristics.
Factors Influencing Duration
- Underlying cause of pericarditis
- Treatment approach
- Individual patient characteristics First-line treatment usually involves NSAIDs like ibuprofen (600-800mg three times daily) or indomethacin (25-50mg three times daily) for 1-2 weeks, often combined with colchicine (0.5-0.6mg once or twice daily) for 3-6 months to prevent recurrences, as supported by the most recent study 1.
Treatment Approach
- First-line: NSAIDs and colchicine
- Second-line: Glucocorticoids for patients with a first recurrence who failed NSAIDs and colchicine and/or have an autoimmune disorder
- Third-line: Interleukin-1 blockers such as anakinra for patients who cannot come off glucocorticoids or as second-line therapy after NSAIDs and colchicine in patients with contraindications to glucocorticoids or high-risk features For refractory cases, corticosteroids, immunosuppressants like azathioprine, or newer biologics such as anakinra may be necessary, as indicated in studies 2, 3. The chronic, relapsing nature of recurrent pericarditis stems from persistent inflammation or autoimmune mechanisms that continue to trigger episodes even after the initial insult has resolved. Complete resolution typically requires long-term anti-inflammatory therapy with careful tapering to minimize the risk of rebound inflammation.