Massimo Imazio, MD; Antonio Brucato, MD; Roberto Cemin, MD; Stefania Ferrua, MD; Riccardo Belli, MD; Silvia Maestroni, MD; Rita Trinchero, MD; David H. Spodick, MD; Yehuda Adler, MD; on behalf of the CORP (COlchicine for Recurrent Pericarditis) Investigators
Recurrence is the most common complication of pericarditis, affecting 10% to 50% of patients.
To evaluate the efficacy and safety of colchicine for the secondary prevention of recurrent pericarditis.
Prospective, randomized, double-blind, placebo-controlled multicenter trial. (ClinicalTrials.gov registration number: NCT00128414)
4 general hospitals in urban areas of Italy.
120 patients with a first recurrence of pericarditis.
In addition to conventional treatment, patients were randomly assigned to receive either placebo or colchicine, 1.0 to 2.0 mg on the first day followed by a maintenance dose of 0.5 to 1.0 mg/d, for 6 months.
The primary study end point was the recurrence rate at 18 months. Secondary end points were symptom persistence at 72 hours, remission rate at 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and rate of constrictive pericarditis.
At 18 months, the recurrence rate was 24% in the colchicine group and 55% in the placebo group (absolute risk reduction, 0.31 [95% CI, 0.13 to 0.46]; relative risk reduction, 0.56 [CI, 0.27 to 0.73]; number needed to treat, 3 [CI, 2 to 7]). Colchicine reduced the persistence of symptoms at 72 hours (absolute risk reduction, 0.30 [CI, 0.13 to 0.45]; relative risk reduction, 0.56 [CI, 0.27 to 0.74]) and mean number of recurrences, increased the remission rate at 1 week, and prolonged the time to subsequent recurrence. The study groups had similar rates of side effects and drug withdrawal.
Multiple recurrences and neoplastic or bacterial causes were excluded.
Colchicine is safe and effective for secondary prevention of recurrent pericarditis.
Maria Vittoria Hospital, Torino, Italy.
Patients who have a recurrence of pericarditis are at high risk for subsequent episodes. Evidence regarding effective treatment and prevention are lacking.
In this study, colchicine hastened the resolution of recurrent pericarditis and reduced the number of further recurrences.
Only patients with a first recurrence of pericarditis were studied.
Colchicine is useful for treatment and prevention after a first recurrence of pericarditis.
The In the Clinic® slide sets are owned and copyrighted by the American College of Physicians (ACP). All text, graphics, trademarks, and other intellectual property incorporated into the slide sets remain the sole and exclusive property of the ACP. The slide sets may be used only by the person who downloads or purchases them and only for the purpose of presenting them during not-for-profit educational activities. Users may incorporate the entire slide set or selected individual slides into their own teaching presentations but may not alter the content of the slides in any way or remove the ACP copyright notice. Users may make print copies for use as hand-outs for the audience the user is personally addressing but may not otherwise reproduce or distribute the slides by any means or media, including but not limited to sending them as e-mail attachments, posting them on Internet or Intranet sites, publishing them in meeting proceedings, or making them available for sale or distribution in any unauthorized form, without the express written permission of the ACP. Unauthorized use of the In the Clinic slide sets will constitute copyright infringement.
Massimo Imazio, Antonio Brucato, Roberto Cemin, Stefania Ferrua, Riccardo Belli, Silvia Maestroni, et al. Colchicine for Recurrent Pericarditis (CORP): A Randomized Trial. Ann Intern Med. 2011;155:409–414. doi: 10.7326/0003-4819-155-7-201110040-00359
Download citation file:
Published: Ann Intern Med. 2011;155(7):409-414.
Cardiology, Pericardial Disease, Prevention/Screening.
Results provided by:
Copyright © 2017 American College of Physicians. All Rights Reserved.
Print ISSN: 0003-4819 | Online ISSN: 1539-3704
Conditions of Use