UMEM Educational Pearls

Title: Colchicine for treatment of acute pericarditis

Keywords: Acute Pericarditis, Colchicine (PubMed Search)

Posted: 9/15/2013 by Ali Farzad, MD (Updated: 3/10/2014)
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Colchicine is known to be effective in treatment of recurrent pericarditis, but until recently its efficacy during the first attack of acute pericarditis has been uncertain.

A recent multicenter, 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:

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
Incessant or recurrent pericarditis: 16% in the colchicine group versus 37% in the control group (relative risk reduction=0.56; CI 0.30-0.72; NNT =4; p < 0.001)
Symptom persistence at 72 hours, recurrences per patient, and hospitalization rate were all significantly reduced in the colchicine group
There were no significant differences in adverse effects or discontinuation of the study drugs

Bottom-line:

Colchicine is a safe and effective drug for the treatment of acute pericarditis. Consider adding colchicine to conventional therapies to reduce duration of symptoms, recurrences, and rate of hospitalization.

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References

Imazio M, Brucato A, Cemin R, et al. A Randomized Trial of Colchicine for Acute Pericarditis. N Engl J Med. 2013 (.pdf attached)

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Attachments

1309151219_NEJM-Colchicine_RCT.pdf (527 Kb)