OBJECTIVES: The purpose of this study was to investigate the efficacy and safety of colchicine for pericarditis prevention. BACKGROUND: Recurrent pericarditis prevention is a major management goal that may reduce morbidity and management costs. Although empiric anti-inflammatory therapy is considered the mainstay of treatment, no specific drug has been proven to be efficacious for prevention but colchicine. METHODS: Controlled clinical studies were searched in several databases and were included provided they focused on the pharmacologic primary or secondary prevention of pericarditis. We performed a meta-analysis including studies primary outcome, adverse events, and drug withdrawal. RESULTS: From the initial sample of 127 citations, five controlled clinical trials were finally included (795 patients): three studies were double-blind randomised controlled trials, and two studies were open-label randomised controlled trials. Trials followed patients for a mean of 13 months. Meta-analytic pooling showed that colchicine use was associated with a reduced risk of pericarditis during follow-up (RR=0.40, 95% CI 0.30 to 0.54, p for effect <0.001, p for heterogeneity = 0.95, I(2)=0%) either for primary or secondary prevention without a significant higher risk of adverse events compared with placebo (RR=1.22, 95% CI 0.71 to 2.10, p for effect 0.48, p for heterogeneity = 0.44, I(2)=0%), but more cases of drug withdrawals (RR=1.85, 95% CI 1.04 to 3.29, p for effect 0.04, p for heterogeneity = 0.42, I(2)=0%). Gastrointestinal intolerance is the most frequent side effect (mean incidence 8%), but no severe adverse events were recorded. CONCLUSIONS: Available evidence suggests that colchicine is safe and efficacious for the primary and secondary prevention of pericarditis.
OBJECTIVES: The purpose of this study was to investigate the efficacy and safety of colchicine for pericarditis prevention. BACKGROUND: Recurrent pericarditis prevention is a major management goal that may reduce morbidity and management costs. Although empiric anti-inflammatory therapy is considered the mainstay of treatment, no specific drug has been proven to be efficacious for prevention but colchicine. METHODS: Controlled clinical studies were searched in several databases and were included provided they focused on the pharmacologic primary or secondary prevention of pericarditis. We performed a meta-analysis including studies primary outcome, adverse events, and drug withdrawal. RESULTS: From the initial sample of 127 citations, five controlled clinical trials were finally included (795 patients): three studies were double-blind randomised controlled trials, and two studies were open-label randomised controlled trials. Trials followed patients for a mean of 13 months. Meta-analytic pooling showed that colchicine use was associated with a reduced risk of pericarditis during follow-up (RR=0.40, 95% CI 0.30 to 0.54, p for effect <0.001, p for heterogeneity = 0.95, I(2)=0%) either for primary or secondary prevention without a significant higher risk of adverse events compared with placebo (RR=1.22, 95% CI 0.71 to 2.10, p for effect 0.48, p for heterogeneity = 0.44, I(2)=0%), but more cases of drug withdrawals (RR=1.85, 95% CI 1.04 to 3.29, p for effect 0.04, p for heterogeneity = 0.42, I(2)=0%). Gastrointestinal intolerance is the most frequent side effect (mean incidence 8%), but no severe adverse events were recorded. CONCLUSIONS: Available evidence suggests that colchicine is safe and efficacious for the primary and secondary prevention of pericarditis.
Authors: Subodh Verma; John W Eikelboom; Stefan M Nidorf; Mohammed Al-Omran; Nandini Gupta; Hwee Teoh; Jan O Friedrich Journal: BMC Cardiovasc Disord Date: 2015-08-29 Impact factor: 2.298
Authors: Syed Raza Shah; Richard Alweis; Syed Arbab Shah; Mohammad Hussham Arshad; Adil Al-Karim Manji; Arham Amir Arfeen; Maheen Javed; Syed Muhammad Shujauddin; Rida Irfan; Sakina Shabbir; Shehryar Shaikh Journal: J Community Hosp Intern Med Perspect Date: 2016-07-06