Published: 5 June 2026
Author(s): Lucia Trotta, Francesco Agozzino, Ruggiero Mascolo, George Lazaros, Antonio Brucato
Issue: June 2026
Section: Letter to the Editor

We thank Zhang and Xu [1,2] for their interest in our work [3]. Regarding the observations of Zhang [1], we agree that observational studies can suggest that a treatment may be beneficial but cannot provide direct or definitive evidence of treatment effect. Randomized controlled trials remain the gold standard. Accordingly, we have clearly stated in the manuscript that our findings should prompt future research, including adequately powered randomized controlled trials to further evaluate the efficacy of hydroxychloroquine (HCQ) in recurrent pericarditis (RP).

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