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Colchicine Treatment for Recurrent Pericarditis FREE

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The full report is titled “Colchicine for Recurrent Pericarditis (CORP).” A Randomized Trial. It is in the 4 October 2011 issue of Annals of Internal Medicine (volume 155, pages 409-414). The authors are M. Imazio, A. Brucato, R. Cemin, S. Ferrua, R. Belli, S. Maestroni, R. Trinchero, D.H. Spodick, and Y. Adler, on behalf of the CORP (COlchicine for Recurrent Pericarditis) Investigators.

Ann Intern Med. 2011;155(7):I-28. doi:10.7326/0003-4819-155-7-201110040-00360
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What is the problem and what is known about it so far?

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.

Why did the researchers do this particular study?

To see whether colchicine can help resolve the symptoms and prevent further recurrences of pericarditis.

Who was studied?

120 patients who had a first recurrence of pericarditis.

How was the study done?

Patients were randomly assigned to receive either colchicine or a placebo pill every day for 6 months. Both groups also received anti-inflammatory drugs.

What did the researchers find?

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.

What were the limitations of the study?

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.

What are the implications of the study?

Colchicine is a safe and effective treatment for some patients who have had their first recurrence of pericarditis.





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