Introduction
Colchicine has been used in diverse clinical settings. Primary idiopathic pericarditis
is complicated by recurrence in 15 to 30% of cases. Aspirin, non-steroidal anti-inflammatory
drugs, colchicine and steroids are the commonly prescribed medications. We synthesised
the available evidence from the randomised trials to assess the efficacy and safety
of colchicine in primary and recurrent pericarditis.
Methods
A systematic search was conducted using MEDLINE, PubMed, EMBASE, Current Contents
Connect, Cochrane library, Google Scholar, Science Direct, and Web of Science. Original
data was abstracted from each study and used to calculate an odds ratio (OR) and 95%
confidence interval (95% CI).
Results
Seven randomised trials comprising 1275 patients met full criteria for analysis. Two
open label randomised controlled trials and five double-blind randomised controlled
trials were included. Colchicine was useful in reducing the incidence of primary pericarditis
(OR: 0.38, 95% CI: 0.22- 0.65) as well as recurrent pericarditis (OR: 0.31, 95% CI:
0.22-0.44). The most common side-effects were related to the gastrointestinal system
and no severe adverse events were observed. Colchicine cessation either by patient
or physician was similar in both groups (OR: 1.53, 95% CI: 0.86-2.71).
Conclusion
Colchicine is effective in preventing both primary and recurrent episodes of pericarditis.
The number needed to treat for preventing recurrent pericarditis was five. Gastrointestinal
side-effects were the most common adverse events.
Keywords
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Article info
Publication history
Published online: February 09, 2015
Accepted:
January 19,
2015
Received in revised form:
August 31,
2014
Received:
November 18,
2013
Identification
Copyright
© 2015 Australian and New Zealand Society of Cardiac and Thoracic Surgeons (ANZSCTS) and the Cardiac Society of Australia and New Zealand (CSANZ). Published by Elsevier Inc. All rights reserved.
