Burden of Disease

Recognizing The Real Impact

Whether it is the first episode or a recurrence, pericarditis can be quite painful and incredibly scary. Patients report that, even if they know the cause, a recurrence still feels like a heart attack, compelling them to go to the emergency room for necessary treatment. Add to that the mounting risk for complications, and the deep clinical burden becomes clear.1-3

It’s not just the physical aspect of managing the symptoms, but also the mental energy of just having to confront that unknown over and over and over again.”
Anna, 36
Pericarditis patient

Clinical Concerns

As pericarditis recurs, so does the need for treatment. Many individuals receive
nonsteroidal anti-inflammatory drugs (NSAIDs) as they did previously along
with other medications as needed, such as colchicine, corticosteroids, or
azathioprine. Side effects associated with these products may vary. None have
been shown to completely prevent future recurrences.4

Medical attention required beyond recurrences

In addition to specific recurrences, recurrent pericarditis carries an elevated risk for significant complications, such as pericardial effusion, cardiac tamponade,and constrictive pericarditis.1

Individuals with recurrent pericarditis also have a high prevalence of cardiovascular comorbidities, including5:
 
Hypertension
Coronary artery disease
Cardiac arrhythmia
Myocardial infarction

As their condition progresses, patients face physical deterioration,
rehospitalization, and impairment in quality of life.3,4,6

While a comprehensive analysis is still needed, this clinical burden clearly
comes at a cost, from hospitalizations and treatments to work time missed
due to disability.2,3

They did an echocardiogram because I was still having a lot of chest pain. And immediately everything changed.”
Dona, 51
Pericarditis patient

Human Hardships

Of course, the clinical challenges of recurrent pericarditis are only half the battle. Pericarditis symptoms and their accompanying limitations on daily life can breed uncertainty. This may affect the patient’s state of mind and emotional health.3

Fearing the future

The physical pain of recurrent pericarditis can directly impact emotional health, quality of life, and work productivity. And for those not currently experiencing a recurrence, fear of the next recurrence is a very real factor of daily life.3

A 2020 study evaluated the impact of recurrent pericarditis on the daily lives of patients in the United States. The researchers conducted a web-based survey of adult patients (≥18 years) with recurrent pericarditis who experienced ≥1 recurrence during the last 12 months. Respondents were asked to provide information on demographic and clinical characteristics. They were also asked to complete a number of assessments on pain and quality of life, and to answer questions about the impact of recurrent pericarditis on daily life.3

83 respondents were included in the analysis, and at the
time of the survey, 25% of respondents were currently
experiencing a recurrence.3 Among the findings:

Depression
Reported by
34%
Anxiety
Reported by
37%
Missed Work Time
Reported by
21%

Among those not experiencing a recurrence, 48% reported
their level of fear of pericarditis as being “quite a bit” or
“very much.”3

Summary

Clinical burden of disease spans
emergent care for flares and long-term
management of complications.1,2

Patients with unresolved recurrent
pericarditis often have 1 or more
cardiovascular comorbidities.5

Recurrent pericarditis symptoms can
have significant impact on emotional
health and quality of life.3

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References:

  1. Chiabrando JG, Bonaventura A, Vecchie A, et al. Management of acute and recurrent pericarditis. J Am Coll Cardiol. 2020;75(1):76-92.
  2. Crotty C, Forsythe A, Magestro M. Unmet needs and burden of recurrent pericarditis (RP): results of a systemic literature review (SLR). Poster presented at: International Society for Pharmacoeconomics and Outcomes Research (ISPOR) 2019 Annual Meeting; May 18-22, 2019; New Orleans, LA. Poster PCV9.
  3. LeWinter MM, Kontzias A, Lin D, et al. Health-related quality of life of patients with recurrent pericarditis in the United States. Poster presented at: Virtual ISPOR 2020; May 18-20, 2020. Poster PCV77.
  4. Cremer PC, Kumar A, Kontzias A, et al. Complicated pericarditis: understanding risk factors and pathophysiology to inform imaging and treatment. J Am Coll Cardiol. 2016;68(21):2311-2328.
  5. Lin D, Majeski C, DerSarkissian M et al. Real-world characteristics and recurrence burden of patients diagnosed with recurrent pericarditis in the United States. Poster presented at: American Heart Association (AHA) Scientific Sessions 2019; November 16-18, 2019; Philadelphia, PA. Poster Su3090.
  6. Mody P, Bikdeli B, Wang Y, Imazio M, Krumholz HM. Trends in acute pericarditis hospitalizations and outcomes among the elderly in the USA, 1999-2012. Eur Heart J Qual Care Clin Outcomes. 2018;4(2):98-105.