Colchicine Administered in the First Episode of Acute Idiopathic Pericarditis: A Randomized Multicenter Open-label Study

Sambola, Antonia; Roca‐Luque, Ivo; Mercé, Jordi; Alguersuari, Joan; Francisco‐Pascual, Jaume; Garcı́a-Dorado, David; Sagristà-Sauleda, Jaume

doi:10.1016/j.rec.2018.11.016

Cited by 18 publications

(11 citation statements)

References 16 publications

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“…In contrast, one recent small open-label study reported neutral effects of colchicine in patients with acute idiopathic pericarditis who had not received corticosteroids. 28 However, in this study, the use of colchicine was delayed, and the diagnostic criteria for pericarditis differed from previous trials and those outlined in the European Society of Cardiology guidelines. 29 Nonetheless, as shown in Figure 5 , when taken together, these trials convincingly demonstrated that colchicine halves the risk of recurrent pericarditis over 18 months.…”

Section: Colchicine For the Treatment Of Acute And Recurrent Pericarditismentioning

confidence: 74%

Colchicine and the heart

Imazio

Nidorf²

2021

European Heart Journal

115

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Colchicine is a unique, sophisticated anti-inflammatory agent that has been used for decades for the prevention of acute inflammatory flares in gout and familial Mediterranean fever. In recent years, clinical trials have demonstrated its potential in a range of cardiovascular (CV) conditions. Colchicine is avidly taken up by leucocytes, and its ability to bind to tubulin and interfere with microtubular function affects the expression of cytokines and interleukins, and the ability of neutrophils to marginate, ingress, aggregate, express superoxide, release neutrophil extracellular traps, and interact with platelets. In patients with acute and recurrent pericarditis, clinical trials in >1600 patients have consistently shown that colchicine halves the risk of recurrence [relative risk (RR) 0.50, 95% confidence interval (CI) 0.42–0.60]. In patients with acute and chronic coronary syndromes, multicentre randomized controlled trials in >11 000 patients followed for up to 5 years demonstrated that colchicine may reduce the risk of CV death, myocardial infarction, ischaemic stroke and ischaemia-driven revascularization by >30% (RR 0.63, 95% CI 0.49–0.81). The use of colchicine at doses of 0.5–1.0 mg daily in CV trials has proved safe. Early gastrointestinal intolerance limits its use in ∼10% of patients; however, ∼90% of patients tolerate it well over the long term. Despite isolated case reports, clinically relevant drug interactions with moderate to strong CYP3A4 inhibitors/competitors or P-glycoprotein inhibitors/competitors are rare if this dosage of colchicine is used in the absence of advanced renal or liver disease. The aim of this review is to summarize the contemporary data supporting the efficacy and safety of colchicine in patients with CV disease.

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Section: Colchicine For the Treatment Of Acute And Recurrent Pericarditismentioning

confidence: 74%

Colchicine and the heart

Imazio

Nidorf²

2021

European Heart Journal

115

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“…Ten clinical trials assessing the efficacy of colchicine in the treatment of pericarditis were located and presented in Table 5 . It should be noted that only two trials reported on the specific etiology underlying the development of pericarditis [ 46 , 47 ], while the remaining eight relied on diagnostic criteria for pericarditis regardless of the pathological condition leading to it.…”

Section: Resultsmentioning

confidence: 99%

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Papadopoulos

Patoulias

Teperikidis

et al. 2020

SN Compr. Clin. Med.

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Coronavirus disease-19 (COVID-19) may result in serious complications involving several organ systems, including myocardial tissue. An exaggerated host inflammatory response, described as a cytokine storm, has been linked to play a major role in these complications. Colchicine and other pharmaceutical agents have been proposed to counter the cytokine storm and improve outcomes. In this exploratory review, we utilized a PubMed and Cochrane Database search aiming to identify the biochemical characteristics of the cytokine storm as well as to identify the potential effect of colchicine on these inflammatory biomarkers. The research yielded 30 reports describing the characteristics of the cytokine storm and 44 reports describing the effect of colchicine on various inflammatory biomarkers. According to our research, colchicine may be an agent of interest in the treatment of COVID-19 via its anti-inflammatory properties. However, there are potential drug interactions with cytochrome P450 3A4 inhibitors resulting in acute colchicine toxicities. Additionally, there is scarce evidence regarding the efficacy of colchicine in the acute phase of disease, since most trials evaluated its effect in chronic conditions. In this direction, our team proposes three different hypotheses for evaluating the place of colchicine in the treatment of COVID-19.

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“…1,2,7 Results of various studies regarding the efficacy of colchicine in treatment and prevention of flares are contradictory. 3,4,8 A recent randomised-controlled multi-centre study did not find any difference in the rate of recurrence or time to first recurrence between patients using only non-steroidal anti-inflammatory drugs and patients using colchicine along with non-steroidal anti-inflammatory drugs. 8 Corticosteroids are widely used in patients unresponsive or resistant to conventional therapy.…”

Section: Discussionmentioning

confidence: 98%

“…3,4,8 A recent randomised-controlled multi-centre study did not find any difference in the rate of recurrence or time to first recurrence between patients using only non-steroidal anti-inflammatory drugs and patients using colchicine along with non-steroidal anti-inflammatory drugs. 8 Corticosteroids are widely used in patients unresponsive or resistant to conventional therapy. However, in addition to the significant side effects, corticosteroid treatment has been reported to be associated with an increased risk of recurrence.…”

Section: Discussionmentioning

confidence: 98%

Anaphylactic reaction to anakinra in a child with steroid-dependent idiopathic recurrent pericarditis and successful management with canakinumab

2019

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Conventional algorithm for treatment of pericarditis and prevention of recurrences consists of non-steroid anti-inflammatory drugs and/or colchicine, followed by corticosteroids in resistant patients. Anakinra has emerged as a promising and safe treatment modality for steroid-dependent idiopathic recurrent pericarditis. However, the efficacy and safety of canakinumab, another anti-interleukin-1 agent, has not been assessed up to date. Herein, we present development of an anaphylactic reaction due to anakinra and a successful subsequent treatment with canakinumab for the first time in the literature.

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Colchicine Administered in the First Episode of Acute Idiopathic Pericarditis: A Randomized Multicenter Open-label Study

Cited by 18 publications

References 16 publications

Colchicine and the heart

Colchicine and the heart

Colchicine as a Potential Therapeutic Agent Against Cardiovascular Complications of COVID-19: an Exploratory Review

Anaphylactic reaction to anakinra in a child with steroid-dependent idiopathic recurrent pericarditis and successful management with canakinumab

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