Abstract
Objective: To assess the safety and efficacy of a novel immunosuppressive regimen—combination Methotrexate/Prednisone (cMtx/P)—in the management of severe refractory rPPP. Methods: In this multicenter, nonrandomized, retrospective, observational study, 408 consecutive patients diagnosed with persistent rPPP between 2017 and 19 were included. Patients with refractory symptoms despite 3 months of conventional therapy were initiated on a 4-week regimen of oral steroids. Persistence of symptoms at this point, that is, rPPP (n = 25; catheter based = 18, open surgical = 7) prompted therapy with Methotrexate (7.5–15 mg weekly) with folate supplementation along with low dose prednisone (5 mg PO) for a further 3 months. Patients were followed for a total of 11.3 ± 1.8 months. Results: Treatment refractory rPPP occurred in 6.1% of the study population prompting immunosuppressive therapy with cMtx/P. All patients demonstrated complete symptom resolution following 3 months of treatment with an 85% decline in clinically significant pericardial effusions. One patient developed recurrent pericarditis during the 11-month follow-up. Therapy was well tolerated with no significant drug related adverse effects. Conclusion: cMtx/P therapy is a safe and effective adjunct in the management of rPPP refractory to standard therapy.
Original language | English (US) |
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Pages (from-to) | 2165-2170 |
Number of pages | 6 |
Journal | Journal of cardiovascular electrophysiology |
Volume | 32 |
Issue number | 8 |
DOIs | |
State | Published - Aug 2021 |
Keywords
- immunosuppression
- methotrexate
- pericarditis
- postablation
- postprocedure
- refractory
- steroids
ASJC Scopus subject areas
- Cardiology and Cardiovascular Medicine
- Physiology (medical)