Disease and Economic Burden Associated with Recurrent Pericarditis in a Privately Insured United States Population

Abstract

Introduction: Approximately 30% of patients with a first acute pericarditis episode experience a recurrence B 18 months; * 15% experience multiple recurrences. This study assessed the recurrence and economic burden among patients with multiple recurrences. Methods: Adults with idiopathic pericarditis were identified in the OptumHealth Care Solutions, Inc., database (2007Inc., database ( -2017. Recurrent pericarditis (RP) was defined as C 2 episodes of care separated by [ 28 days; multiple recurrences were defined as C 2 recurrences. Results: Among 944 patients with RP, 375 (39.7%) experienced multiple recurrences and were propensity score-matched 1:1 to 375 patients without recurrence. Among patients with multiple recurrences, median disease duration (time from first episode to end of last recurrence, confirmed by a 1.5-year recurrencefree period) was 2.84 years. The multiple recurrences cohort had higher rates of hospitalizations per-patient-per-month (PPPM) than the no recurrence cohort (rate ratio [95% confidence interval (CI)] = 2.22 [1.35-3.65]). Mean total healthcare costs were significantly higher in the multiple recurrences versus no recurrence cohort

Interleukin-1 Blockers: A Paradigm Shift in the Treatment of Recurrent Pericarditis

“…A third recurrence is observed in 20–40% of cases. Notably, approximately 6% of patients with recurrent disease will develop multiple recurrences (≥3) with a median duration of disease activity estimated between 2.8 and 4.7 years [ 6 , 21 , 22 , 23 , 24 ]. This troublesome subset of patients sometimes depicts an incessant clinical course and falls into the so-called colchicine-resistant glucocorticoid-dependent recurrent pericarditis group [ 5 ].…”

Advances in Imaging and Targeted Therapies for Recurrent Pericarditis

“…Once the diagnosis of recurrent pericarditis is established, management involves a combination of anti-inflammatory drugs, often leading to steroid dependence in refractory cases . The mean duration of recurrent pericarditis in patients who are difficult to treat can be remarkably long (up to 4.7-6.2 years) from the onset until the complete suspension of therapy adding substantially to morbidity and health care costs . The purpose of this review is to guide clinicians on the current diagnostic and therapeutic approach for recurrent pericarditis with emphasis on what is new since the 2015 European Society of Cardiology (ESC) guidelines.…”

Absence of Pericarditis Recurrence in Rilonacept-Treated Patients With COVID-19 and SARS-CoV-2 Vaccination: Results From the RHAPSODY Long-term Extension

“…Recurrent pericarditis (RP) is a chronic autoinflammatory disease of 3-year median duration requiring prolonged treatment to prevent recurrence. 1 , 2 , 3 The interleukin-1 (IL-1) cytokine family dominates the inflammatory response in RP, and IL-1 pathway inhibition reduces recurrence risk in patients with RP. 4 Rilonacept reduced pericarditis recurrence risk by 96% (hazard ratio in a Cox proportional-hazards model, 0.04; 95% confidence interval, 0.01-0.18; P < 0.0001 by log-rank test) in the phase-3 study R ilonacept In h ibition of Interleukin-1 A lpha and Beta for Recurrent P ericarditis: a Pivotal S ymptomatology and O utcomes Stud y (RHAPSODY).…”