Pericarditis is a type of heart disease that mostly affects men in their 20s through 50s. But women and people of just about any age can also develop this painful condition, in which the thin fluid-filled sac (pericardium) that surrounds the heart becomes inflamed.
But there is new hope for men and women who experience a particular type of this condition: recurrent pericarditis. People with recurrent pericarditis have episodes that last for months.
“Many of my patients can suffer debilitating pain that prevents them from working and even exercising, and that negatively impacts their quality of life,” says Allan Klein, MD, director of Cleveland Clinic’s Center for the Diagnosis and Treatment of Pericardial Diseases.
Recurrent pericarditis is one of the hardest forms of the disease to treat. Two new medications, however, are showing encouraging results in clinical trials. These drugs may prove to be effective at preventing episodes, rather than just treating pericarditis symptoms.
The new medications being studied are anakinra, an interleukin 1 Beta recombinant receptor antagonist, and canakinumab, another interleukin receptor blocker. The drugs work by changing the way the immune system responds to a variety of triggers.
Promising study results have been published in a few journals, and more data should be revealed later this year.
One of the reasons Dr. Klein and other pericarditis specialists are so encouraged is that many people with recurrent pericarditis don’t respond well to certain anti-inflammatory drugs that might otherwise ease their chest pain and other symptoms. Steroids are often needed, but they have unwanted side effects.
Flare-ups of autoimmune diseases, such as lupus and rheumatoid arthritis, can trigger bouts of recurrent pericarditis. But a viral infection may be the most common cause of acute pericarditis episodes.
It’s not always obvious why a person develops pericarditis, though it affects an estimated one in five heart attack survivors. Pericarditis tends to come on suddenly.
“Ninety percent of my patients have pericarditis following a bout with a virus such as the flu or from unknown causes,” Dr. Klein says. Other triggers include heart surgery and trauma to the chest.