Colchicine Treatment for Recurrent Pericarditis. Ann Intern Med. 2011;155:I-28. doi: 10.7326/0003-4819-155-7-201110040-00360
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Published: Ann Intern Med. 2011;155(7):I-28.
Pericarditis is the inflammation of a sac that surrounds the heart. It can occur after cardiac surgery; from viral infections, tuberculosis, cancer, or an autoimmune disease; or, commonly, for no identifiable reason. Pericarditis usually causes pain and sometimes it causes life-threatening fluid accumulation around the heart. Although patients benefit from treatment with anti-inflammatory drugs (such as aspirin, ibuprofen, or a steroid), pericarditis frequently recurs. Recurrences are a troublesome complication of pericarditis, occurring in about one third of patients with acute pericarditis and up to 50% of patients with a first recurrence. Some patients have been treated with another drug, colchicine, although data from well-done clinical trials are limited.
To see whether colchicine can help resolve the symptoms and prevent further recurrences of pericarditis.
120 patients who had a first recurrence of pericarditis.
Patients were randomly assigned to receive either colchicine or a placebo pill every day for 6 months. Both groups also received anti-inflammatory drugs.
Symptoms of pericarditis resolved within 1 week more often for patients who received colchicine than for those who received placebo. Patients who received colchicine had about half the number of additional episodes of pericarditis during the following 18 months than those who received placebo. Gastrointestinal symptoms (such as diarrhea, nausea, or discomfort) were the most frequent side effects, occurring in 7% of the patients in both groups.
Patients whose pericarditis was caused by specific infections or cancer, women who were pregnant or breastfeeding, and those who had already had more than 1 recurrence of pericarditis were not studied. Whether colchicine would be beneficial or safe for such patients is unknown. It is also not known how long treatment should be continued. Colchicine is not approved for the treatment of pericarditis in the United States or Europe, and this use is considered off-label.
Colchicine is a safe and effective treatment for some patients who have had their first recurrence of pericarditis.
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Cardiology, Pericardial Disease.
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