From the Research
The initial treatment approach for arthritis associated with pericardial effusion should involve high-dose nonsteroidal anti-inflammatory drugs (NSAIDs) and a 3-month course of colchicine to relieve symptoms and reduce the risk of recurrence, as recommended by the most recent and highest quality study 1. The treatment strategy should target the underlying inflammatory process that affects both the joints and pericardium, which often share a common autoimmune or inflammatory pathophysiology.
- Key considerations include:
- High-dose NSAIDs, such as ibuprofen or indomethacin, should be used to control symptoms and inflammation.
- Colchicine should be added to enhance the anti-inflammatory effect and prevent recurrence, typically continued for 3-6 months.
- Gastroprotection with a proton pump inhibitor, such as omeprazole, should be considered when using NSAIDs.
- Corticosteroids, such as prednisone, may be introduced for cases resistant to the initial approach, but should be reserved for refractory cases or specific etiologies due to potential side effects. The most recent study 1 provides the strongest evidence for this treatment approach, and its recommendations should be prioritized to optimize outcomes in terms of morbidity, mortality, and quality of life.
- The study highlights the importance of a 3-month course of colchicine in reducing the risk of recurrence and relieving symptoms, with an absolute risk reduction of 20.8% compared to NSAIDs alone.
- The use of high-dose NSAIDs and colchicine is supported by the study as an effective treatment strategy for acute idiopathic and pericarditis after cardiac procedures or operations.