Home > General Cardiology, Journal Club > Journal Club 13 November 2013

Journal Club 13 November 2013

Paper

A Randomized Trial of Colchicine for Acute Pericarditis

Presenter

SH

Summary

Background

Colchicine is effective for the treatment of recurrent pericarditis. However, conclusive
data are lacking regarding the use of colchicine during a first attack of acute
pericarditis and in the prevention of recurrent symptoms.

Methods

In a multicenter, double-blind trial, eligible adults with acute pericarditis were
randomly assigned to receive either colchicine (at a dose of 0.5 mg twice daily for
3 months for patients weighing >70 kg or 0.5 mg once daily for patients weighing
≤70 kg) or placebo in addition to conventional antiinflammatory therapy with aspirin
or ibuprofen. The primary study outcome was incessant or recurrent pericarditis.

Results

A total of 240 patients were enrolled, and 120 were randomly assigned to each of
the two study groups. The primary outcome occurred in 20 patients (16.7%) in the
colchicine group and 45 patients (37.5%) in the placebo group (relative risk reduction
in the colchicine group, 0.56; 95% confidence interval, 0.30 to 0.72; number
needed to treat, 4; P<0.001). Colchicine reduced the rate of symptom persistence at
72 hours (19.2% vs. 40.0%, P = 0.001), the number of recurrences per patient (0.21
vs. 0.52, P = 0.001), and the hospitalization rate (5.0% vs. 14.2%, P = 0.02). Colchicine
also improved the remission rate at 1 week (85.0% vs. 58.3%, P<0.001). Overall
adverse effects and rates of study-drug discontinuation were similar in the two
study groups. No serious adverse events were observed.

Conclusions

In patients with acute pericarditis, colchicine, when added to conventional antiinflammatory
therapy, significantly reduced the rate of incessant or recurrent
pericarditis.

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