[FRSM]

Colchicine prevents recurrent pericarditis
Ann Intern Med 2011;155


Up to one in three patients with pericarditis experiences a
recurrence, and up to half of these go on to experience a further
episode. The preventive effects of colchicine were tested in a
placebo controlled trial. It was added to standard treatment, at
a dose of 1.0–2.0 mg on the first day and at 0.5–1.0 mg/day for
the next six months. The 120 participants were patients with a
first recurrence of endocarditis.
In a year and a half, just under a quarter of patients who had
received colchicine experienced another episode of pericarditis,
compared with over half of those allocated to placebo. Three
patients (95% CI 2 to 7) needed to be treated with colchicine to
avert one additional episode of pericarditis. Secondary outcomes
were also improved with colchicine: symptoms on day three of
pericarditis, remission at one week, number of recurrences over
a year and half, and time to the next recurrence.
All adverse side effects occurred in the first week of treatment,
and rates were similar with colchicine and placebo (7% for both
groups). Gastrointestinal intolerance was the most common. No
life threatening or serious events requiring admission to hospital
were seen.