Colchicine in Addition to Conventional Therapy for Acute Pericarditis

Abstract

Background-Colchicine is effective and safe for the treatment and prevention of recurrent pericarditis and might ultimately serve as the initial mode of treatment, especially in idiopathic cases. The aim of this work was to verify the safety and efficacy of colchicine as an adjunct to conventional therapy for the treatment of the first episode of acute pericarditis. Methods and Results-A prospective, randomized, open-label design was used. A total of 120 patients (mean age 56.9Ϯ18.8 years, 54 males) with a first episode of acute pericarditis (idiopathic, viral, postpericardiotomy syndromes, and connective tissue diseases) were randomly assigned to conventional treatment with aspirin (group I) or conventional treatment plus colchicine 1.0 to 2.0 mg for the first day and then 0.5 to 1.0 mg/d for 3 months (group II). Corticosteroid therapy was restricted to patients with aspirin contraindications or intolerance.

Clinical Profile and Influences on Outcomes in Patients Hospitalized for Acute Pericarditis

“…[5][6][7] A recent randomized trial of 240 patients with acute pericarditis found 60% were male, 6 whereas previous studies have reported higher male prominence 7 but also female prominence. 5 We found 65% of 1361 patients to be male, and the age-adjusted likelihood of an acute pericarditis patient being male was 1.9. Furthermore, the incidence rate of acute pericarditis in the general adult population was 2-fold among men compared with women.…”

“…1,2 Experimental studies have found males to be at higher risk for acute viral heart disease, 3,4 but clinical studies have reported conflicting results on sex distribution of acute pericarditis patients. [5][6][7] It is commonly thought that there is no specific sex predisposition to pericarditis. 8 Murine studies have also found the susceptibility for viral heart disease to be significantly age dependent, with the highest sensitivity at adolescence or young adulthood.…”

Pericardiectomy vs Medical Management in Patients With Relapsing Pericarditis

“…Current recommendations on the management of relapsing pericarditis include treatment with nonsteroidal anti-inflammatory drugs (NSAIDs) and colchicine for the initial relapse, 5 corticosteroids for patients in whom initial medical therapy has failed, and possibly immunosuppressive agents for patients in whom an autoimmune or inflammatory disease is the underlying cause. 3,6 Although the use of corticosteroids for relapsing pericarditis can provide relatively rapid relief of symptoms, multiple studies have suggested that corticosteroid administration may favor relapses [4][5][6][7][8][9][10][11] and also predisposes the patient to multiple adverse events.…”

The Dilemma of acute myocarditis and acute myocardial infarction: a case report

“…In acute myopericarditis, nonsteriod antiinflammatory drugs use as initial therapy, especially ibuprofen is preferred because of the wide range of doses and safety (10). Because of corticosteroids can cause to recurrent pericarditis attacks; it is recommended to use in a controlled manner, it is added to treatment if there is no response to NSAIDs and colchicine (11). Because of his age, history, risk factors, concave ST elevation and PR depression NSAII was performed to our patient principally by intramuscularly.…”