Arthritis & Rheumatism, Volume 63,
November 2011 Abstract Supplement
Abstracts of the American College of
Rheumatology/Association of Rheumatology Health Professionals
Annual Scientific Meeting
Chicago, Illinois November 4-9, 2011.
Colchicine Halves, but Does Not Eliminate Recurrences in Pericarditis: Colchicine for Recurrent Pericarditis. A Randomized, Controlled Trial.
Brucato1, A., Maestroni1, S., Cumetti1, D., Cemin2, R., Ferrua3, S., Belli4, R., Spodick5, D. H.
Ospedali Riuniti, Bergamo, Italy
San Maurizio Regional Hospital, Bolzano, Italy
Savigliano Hospital, Rivoli, Italy
Maria Vittoria Hospital, Torino, Italy
St. Vincent Hospital, Massachusetts
Sackler Faculty of Medicine, Tel-Aviv, Israel
Recurrences are the most common complication of acute pericarditis (20 to 50% of cases). Aim of this study is to evaluate the efficacy and safety of colchicine for the secondary prevention of recurrent pericarditis.
This is a prospective, randomized, double-blind, placebo-controlled, multicentric trial; 120 Italian patients with a first episode of recurrent pericarditis were enrolled. Patients were randomized to receive placebo or colchicine on top of a conventional treatment (aspirin, NSAIDs and/or corticosteroids). Colchicine was given at the dose of 1.0 to 2.0 mg for the first day followed by a maintenance dose of 0.5 to 1.0 mg daily for 6 months. The primary study end point was the recurrence rate at 18 months. The secondary end points were symptom persistence at 72 hours, remission rate at 1 week, number of recurrences, time to first recurrence, disease-related hospitalization, cardiac tamponade, and constrictive pericarditis rates.
Colchicine significantly reduced the actuarial incidence of recurrences at 18 months compared to placebo (23.9% vs. 55.3%; p<0.001; number needed to treat-NNT 3). Colchicine also significantly reduced the symptoms persistence at 72 hours (23.3% vs. 53.3%; p=0.001), and the mean number of recurrences. Colchicine increased the remission rate at 1 week (81.7% vs. 48.3%; p<0.001) and prolonged the time to a subsequent recurrence. The rate of side effects and drug withdrawal were similar in the colchicine and placebo groups (respectively, 6.7% vs. 6.7% for side effects, 8.3% vs. 5.0% for drug withdrawal).
Colchicine is safe and efficacious for the secondary prevention of recurrent pericarditis. It halves recurrences, but does not eliminate them.
To cite this abstract, please use the following information:
Brucato, A., Maestroni, S., Cumetti, D., Cemin, R., Ferrua, S., Belli, R., et al; Colchicine Halves, but Does Not Eliminate Recurrences in Pericarditis: Colchicine for Recurrent Pericarditis. A Randomized, Controlled Trial. [abstract]. Arthritis Rheum 2011;63 Suppl 10 :1051