Title: Colchicine for treatment of acute pericarditis<br/>Author: Ali Farzad<br/><a href='http://umem.org/profiles/faculty/737/'>[Click to email author]</a><hr/><p>
<span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">Colchicine is known to be effective in treatment of recurrent pericarditis, but until recently its efficacy </span><i style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">during the first attack of acute pericarditis</i><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;"> has been uncertain. </span><br style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;" />
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<span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">A recent multi</span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">center, double-blinded, RCT of patients with acute pericarditis found colchicine to be effective in reducing the rate of incessant or recurrent pericarditis (primary outcome), as well as the rate of hospitalization. Here are some highlights:</span></p>
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240 patients with acute pericarditis received conventional therapy (aspirin or ibuprofen), half of them were randomized to also get colchicine, the other half to placebo for 3 months</li>
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Incessant or recurrent pericarditis: 16% in the colchicine group versus 37% in the control group (relative risk reduction
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=</div>
0.56; CI 0.30-0.72; <b>NNT</b>
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<b>=</b></div>
<b>4</b>; p < 0.001)</li>
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Symptom persistence at 72 hours, recurrences per patient, and hospitalization rate were all significantly reduced in the colchicine group</li>
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There were no significant differences in adverse effects or discontinuation of the study drugs</li>
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<b style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;"><u>Bottom-line:</u> Colchicine is a cheap, safe, and effective drug for the treatment of acute </b><b style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">pericarditis. </b><strong><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">Consider adding colchicine to conventional therapies to reduce duration of symptoms, recurrences, </span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">and rate of hospitalization. </span></strong></p>
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<span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">Imazio M, Brucato A, Cemin R, et al. A Randomized Trial of Colchicine for Acute Pericarditis. N Engl J Med. 2013 (.pdf attached)</span></p>
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<strong><font face="georgia, serif" style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">Do you know the ECG findings </font><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">of p</span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">ericarditis and how to differentiate from other causes of diffuse ST-segment elevation? Check out these previous ECG </span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">v</span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">ideo</span><span style="color: rgb(0, 0, 0); font-family: georgia, serif; font-size: small;">s to refresh your memory...</span></strong></p>
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<a href="http://tmblr.co/Zls-wvGjwFeF"><font face="trebuchet ms, sans-serif"><b><span style="text-align: justify; margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="color: rgb(0, 0, 255); margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;">Emergent causes of Diffuse ST-segment Elevation</span></span></span></span></span></b></font></a></p>
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<span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><font face="trebuchet ms, sans-serif"><b><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><a href="http://tmblr.co/Zls-wvL2Jtk5" style="color: rgb(17, 85, 204); margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;" target="_blank"><span style="color:#0000ff;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"></span></span></span><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline; text-align: center;">STEMI vs. Benign early repolarization vs. Pericarditis</span></span></a></span></span></b></font></span></span></span></span></p>
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<span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><font face="trebuchet ms, sans-serif"><b><span style="text-align: start; margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline; text-align: center;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><a href="http://tmblr.co/Zls-wvY4vN8q" style="color: rgb(17, 85, 204); text-align: start; margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;" target="_blank"><span style="color:#0000ff;">Spodick’s Sign</span></a></span></span></span></b></font></span></span></span></span></span></p>
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<span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="text-align: start; margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline; text-align: center;"><font face="trebuchet ms, sans-serif"><b><a href="http://tmblr.co/Zls-wvSlu7aF" style="color: rgb(17, 85, 204); text-align: justify; margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;" target="_blank"><span style="color:#0000ff;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline; text-align: center;"><span style="margin: 0px; padding: 0px; border: 0px; outline: 0px; vertical-align: baseline;">ECG findings in Pericarditis vs. STEMI</span></span></span></span></a></b></font></span></span></span></span></span></span></span></p>
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<span style="line-height: normal; background-color: transparent;"><font face="trebuchet ms, sans-serif"><b><a href="http://ekgumem.tumblr.com/tagged/Pericarditis" style="color: rgb(17, 85, 204);" target="_blank"><span style="color:#0000ff;">#Pericarditis</span></a></b></font></span></p>
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</fieldset><fieldset><legend>Attachments</legend>
NEJM-Colchicine_RCT.pdf (527 Kb)<br/><a href='http://umem.org/files/uploads/1309151219_NEJM-Colchicine_RCT.pdf' target='_blank'>http://umem.org/files/uploads/1309151219_NEJM-Colchicine_RCT.pdf</a><br/><br/></fieldset>