Colchicine for pericarditis

Colchicine as adjunctive therapy to NSAIDs appears to be effective in reducing the number of further recurrences in patients with recurrent pericarditis or acute pericarditis.

The quality of evidence is downgraded by study limitations (lack of blinding).

Summary

A Cochrane review included 4 studies with a total of 564 subjects. The effects of colchicine in addition to a non-steroidal anti-inflammatory drug (NSAID) such as ibuprofen, aspirin or indomethacin was compared to the effects of the NSAID alone. Two studies included patients with recurrent pericarditis and 2 studies patients with acute pericarditis.

In people with recurrent pericarditis colchicine reduced episodes of pericarditis (HR 0.37, 95% CI 0.24 to 0.58; 2 studies, n=204; NNT = 4 at 18 months), and in acute pericarditis colchicine reduced recurrence (HR 0.40, 95% CI 0.27 to 0.61; 2 studies, n=360) over 18 months follow-up. Colchicine led to a greater chance of symptom relief at 72 hours. Recurrences at different time points are shown in table .

Adverse effects were mainly gastrointestinal and included abdominal pain and diarrhoea. There was no statistically significant difference in adverse events between the groups, but treatment with colchicine led to more people stopping treatment due to adverse events (table ).

Clinical comments

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Ədəbiyyat

1. Alabed S, Cabello JB, Irving GJ et al. Colchicine for pericarditis. Cochrane Database Syst Rev 2014;(8):CD010652.