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US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis
BACKGROUND: Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. METHODS AND RESULTS: This retrospective US database analysis included newly diagnosed patien...
Autores principales: | , , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
John Wiley and Sons Inc.
2021
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Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475691/ https://www.ncbi.nlm.nih.gov/pubmed/34284595 http://dx.doi.org/10.1161/JAHA.120.018950 |
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author | Klein, Allan Cremer, Paul Kontzias, Apostolos Furqan, Muhammad Tubman, Ryan Roy, Mike Lim‐Watson, Michelle Z. Magestro, Matthew |
author_facet | Klein, Allan Cremer, Paul Kontzias, Apostolos Furqan, Muhammad Tubman, Ryan Roy, Mike Lim‐Watson, Michelle Z. Magestro, Matthew |
author_sort | Klein, Allan |
collection | PubMed |
description | BACKGROUND: Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. METHODS AND RESULTS: This retrospective US database analysis included newly diagnosed patients with RP with ≥24 months of continuous history following their first pericarditis episode. RP was defined as ≥2 pericarditis episodes ≥28 days apart. Some patients had ≥2 recurrences, while others had a single recurrence with a serious complication, ie, constrictive pericarditis, cardiac tamponade, or a large pericardial effusion with pericardiocentesis/pericardial window. Among these patients with multiple recurrences and/or complications, some had features relating to treatment history, including long‐term corticosteroid use (corticosteroids started within 30 days of flare, continuing ≥90 consecutive days) or inadequate treatment response (pericarditis recurring despite corticosteroids and/or colchicine, or other drugs [excluding NSAIDs] within 30 days of flare, or prior pericardiectomy). Patients (N=2096) had hypertension (60%), cardiomegaly (9%), congestive heart failure (17%), atrial fibrillation (16%), autoimmune diseases (18%), diabetes mellitus (21%), renal disease (20%), anxiety (21%), and depression (14%). Complications included pericardial effusion (50%), cardiac tamponade (9%), and constrictive pericarditis (4%). Pharmacotherapy included colchicine (51%), NSAIDs (40%), and corticosteroids (30%), often in combination. This study estimates 37 000 US patients with RP; incidence was 6.0/100 000/year (95% CI, 5.6‒6.3), and prevalence was 11.2/100 000 (95% CI, 10.6‒11.7). CONCLUSIONS: Patients with RP may have multiple recurrences and/or complications, often because of inadequate treatment response and persistent underlying disease. Corticosteroid use is frequent despite known side‐effect risks, potentially exacerbated by prevalent comorbidities. Substantial clinical burden and lack of effective treatments underscore the high unmet need. |
format | Online Article Text |
id | pubmed-8475691 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2021 |
publisher | John Wiley and Sons Inc. |
record_format | MEDLINE/PubMed |
spelling | pubmed-84756912021-10-01 US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis Klein, Allan Cremer, Paul Kontzias, Apostolos Furqan, Muhammad Tubman, Ryan Roy, Mike Lim‐Watson, Michelle Z. Magestro, Matthew J Am Heart Assoc Original Research BACKGROUND: Patients with recurrent pericarditis (RP) may develop complications, multiple recurrences, or inadequate treatment response. This study aimed to characterize disease burden and unmet needs in RP. METHODS AND RESULTS: This retrospective US database analysis included newly diagnosed patients with RP with ≥24 months of continuous history following their first pericarditis episode. RP was defined as ≥2 pericarditis episodes ≥28 days apart. Some patients had ≥2 recurrences, while others had a single recurrence with a serious complication, ie, constrictive pericarditis, cardiac tamponade, or a large pericardial effusion with pericardiocentesis/pericardial window. Among these patients with multiple recurrences and/or complications, some had features relating to treatment history, including long‐term corticosteroid use (corticosteroids started within 30 days of flare, continuing ≥90 consecutive days) or inadequate treatment response (pericarditis recurring despite corticosteroids and/or colchicine, or other drugs [excluding NSAIDs] within 30 days of flare, or prior pericardiectomy). Patients (N=2096) had hypertension (60%), cardiomegaly (9%), congestive heart failure (17%), atrial fibrillation (16%), autoimmune diseases (18%), diabetes mellitus (21%), renal disease (20%), anxiety (21%), and depression (14%). Complications included pericardial effusion (50%), cardiac tamponade (9%), and constrictive pericarditis (4%). Pharmacotherapy included colchicine (51%), NSAIDs (40%), and corticosteroids (30%), often in combination. This study estimates 37 000 US patients with RP; incidence was 6.0/100 000/year (95% CI, 5.6‒6.3), and prevalence was 11.2/100 000 (95% CI, 10.6‒11.7). CONCLUSIONS: Patients with RP may have multiple recurrences and/or complications, often because of inadequate treatment response and persistent underlying disease. Corticosteroid use is frequent despite known side‐effect risks, potentially exacerbated by prevalent comorbidities. Substantial clinical burden and lack of effective treatments underscore the high unmet need. John Wiley and Sons Inc. 2021-07-21 /pmc/articles/PMC8475691/ /pubmed/34284595 http://dx.doi.org/10.1161/JAHA.120.018950 Text en © 2021 The Authors and Kiniksa Pharmaceuticals. Published on behalf of the American Heart Association, Inc., by Wiley. https://creativecommons.org/licenses/by-nc/4.0/This is an open access article under the terms of the http://creativecommons.org/licenses/by-nc/4.0/ (https://creativecommons.org/licenses/by-nc/4.0/) License, which permits use, distribution and reproduction in any medium, provided the original work is properly cited and is not used for commercial purposes. |
spellingShingle | Original Research Klein, Allan Cremer, Paul Kontzias, Apostolos Furqan, Muhammad Tubman, Ryan Roy, Mike Lim‐Watson, Michelle Z. Magestro, Matthew US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title | US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title_full | US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title_fullStr | US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title_full_unstemmed | US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title_short | US Database Study of Clinical Burden and Unmet Need in Recurrent Pericarditis |
title_sort | us database study of clinical burden and unmet need in recurrent pericarditis |
topic | Original Research |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC8475691/ https://www.ncbi.nlm.nih.gov/pubmed/34284595 http://dx.doi.org/10.1161/JAHA.120.018950 |
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