Skip to main content
SpringerLink
Log in

Colchicine in addition to conventional therapy for pericarditis recurrence

An update meta-analysis

Colchicin zusätzlich zur konventionellen Therapie bei Perikarditisrezidiv

Eine aktualisierte Metaanalyse

  • Original articles
  • Published:
Herz Aims and scope Submit manuscript

Abstract

Background

Randomized controlled trials (RCTs) have investigated the use of colchicine and conventional therapy for reducing the recurrence of pericarditis in patients with acute pericarditis or post-pericardiotomy syndrome. However, the benefits of these treatments are variable.

Methods

Studies were retrieved from PubMed, the Cochrane Library, and the EMBASE database.

Results

We identified nine RCTs with 1832 patients and a mean follow-up of 13.1 months. Overall, colchicine therapy significantly decreased the risk of pericarditis recurrence (odds ratio, OR 0.42; 95 % confidence interval, CI 0.33–0.52; P < 0.001; I2 = 17.0 %). Colchicine therapy was associated with significantly lower rates of pericarditis-associated rehospitalization (OR 0.29; 95 % CI 0.16–0.53; P < 0.0001; I2 = 0.0 %) and persistence of symptoms (OR 0.29; 95 % CI, 0.21–0.41; P = 0.000; I2 = 0.0 %) at 72 h. Adverse events were higher in the colchicine group (relative risk, RR 1.48; 95 % CI, 1.06–2.07; P = 0.02; I2 = 0.0 %). Subgroup analysis showed that recurrence of pericarditis was significantly lower in the colchicine therapy group, irrespective of prednisone use and the cause of pericarditis.

Conclusion

Colchicine significantly decreases the rate of pericarditis recurrence, regardless of prednisone use and the cause of pericarditis. Larger studies are needed to confirm this effect.

Zusammenfassung

Hintergrund

In randomisierten kontrollierten Studien (RCT) wurde der Einsatz von Colchicin und konventioneller Therapie untersucht, um das Risiko von Perikarditisrezidiven bei Patienten mit akuter Perikarditis oder Postperikardiotomiesyndrom zu senken. Der Nutzen dieser Behandlungen ist jedoch unterschiedlich.

Methoden

Entsprechende Studien wurden in den Datenbanken PubMed, Cochrane Library und EMBASE gesucht.

Ergebnisse

Die Autoren fanden 9 RCT mit 1832 Patienten und einer durchschnittlichen Nachbeobachtungsdauer von 13,1 Monaten. Insgesamt senkte die Colchicintherapie das Risiko eines Perikarditisrezidivs signifikant (Odds Ratio, OR: 0,42; 95 %-Konfidenzintervall, 95%-KI: 0,33–0,52; p < 0,001; I2 = 17,0 %). Die Colchicintherapie ging mit einer signifikant niedrigeren Rate an perikarditisbedingten stationären Wiederaufnahmen (OR: 0,29; 95 %-KI: 0,16–0,53; p < 0,0001; I2 = 0,0 %) und an Symptompersistenz (OR: 0,29; 95 %-KI: 0,21–0,41; p = 0,000; I2 = 0,0 %) nach 72 h einher. Unerwünschte Ereignisse traten häufiger in der Colchicingruppe auf (relatives Risiko, RR: 1,48; 95 %-KI: 1,06–2,07; p = 0,02; I2 = 0,0 %). Die Subgruppenanalyse zeigte, dass Perikarditisrezidive in der Gruppe mit Colchicintherapie signifikant niedriger waren, unabhängig vom Einsatz von Prednison und von der Ursache der Perikarditis.

Schlussfolgerung

Colchicin senkt die Rate an Perikarditisrezidiven signifikant, ungeachtet des ggf. erfolgenden Prednisoneinsatzes und der Perikarditisursache. Größere Studien sind erforderlich, um dies zu bestätigen.

This is a preview of subscription content, log in via an institution to check access.

Access this article

Log in via an institution

Price excludes VAT (USA)
Tax calculation will be finalised during checkout.

Instant access to the full article PDF.

Institutional subscriptions

Fig. 1
Fig. 2
Fig. 3
Fig. 4
Fig. 5
Fig. 6
Fig. 7
Fig. 8

Similar content being viewed by others

References

  1. Crittenden DB, Pillinger MH (2013) New therapies for gout. Annu Rev Med 64:325–337

    Article  CAS  PubMed  Google Scholar 

  2. Cocco G, Chu DC, Pandolfi S (2010) Colchicine in clinical medicine. A guide for internists. Eur J Intern Med 21:503–508

    Article  CAS  PubMed  Google Scholar 

  3. Imazio M, Trinchero R, Brucato A, Rovere ME, Gandino A, Cemin R, Ferrua S, Maestroni S, Zingarelli E, Barosi A, Simon C, Sansone F, Patrini D, Vitali E, Ferrazzi P, Spodick DH, Adler Y, COPPS Investigators (2010) Colchicine for the prevention of the post-pericardiotomy syndrome (COPPS): a multicentre, randomized, double-blind, placebo-controlled trial. Eur Heart J 31:2749–2754

    Article  CAS  PubMed  Google Scholar 

  4. Imazio M, Bobbio M, Cecchi E, Demarie D, Demichelis B, Pomari F, Moratti M, Gaschino G, Giammaria M, Ghisio A, Belli R, Trinchero R (2005) Colchicine in addition to conventional therapy for acute pericarditis: results of the colchicine for acute pericarditis (COPE) trial. Circulation 112:2012–2016

    Article  CAS  PubMed  Google Scholar 

  5. Imazio M, Brucato A, Trinchero R, Spodick D, Adler Y (2009) Colchicine for pericarditis: hype or hope? Eur Heart J 30:532–539

    Article  CAS  PubMed  Google Scholar 

  6. Moher D, Liberati A, Tetzlaff J, Altman DG (2009) Preferred reporting items for systematic reviews and meta-analyses: the prisma statement. J Clin Epidemiol 62:1006–1012

    Article  PubMed  Google Scholar 

  7. DerSimonian R, Laird N (1986) Meta-analysis in clinical trials. Control Clin Trials 7:177–188

    Article  CAS  PubMed  Google Scholar 

  8. Finkelstein Y, Shemesh J, Mahlab K, Abramov D, Bar-El Y, Sagie A, Sharoni E, Sahar G, Smolinsky AK, Schechter T, Vidne BA, Adler Y (2002) Colchicine for the prevention of postpericardiotomy syndrome. Herz 27:791–794

    Article  PubMed  Google Scholar 

  9. Imazio M, Bobbio M, Cecchi E, Demarie D, Pomari F, Moratti M, Ghisio A, Belli R, Trinchero R (2005) Colchicine as first-choice therapy for recurrent pericarditis: results of the CORE (colchicine for recurrent pericarditis) trial. Arch Intern Med 165:1987–1991

    Article  CAS  PubMed  Google Scholar 

  10. Imazio M, Brucato A, Cemin R, Ferrua S, Belli R, Maestroni S, Trinchero R, Spodick DH, Adler Y, CORP (COlchicine for Recurrent Pericarditis) Investigators (2011) Colchicine for recurrent pericarditis (CORP): a randomized trial. Ann Intern Med 155:409–414

    Article  PubMed  Google Scholar 

  11. Imazio M, Brucato A, Cemin R, Ferrua S, Maggiolini S, Beqaraj F, Demarie D, Forno D, Ferro S, Maestroni S, Belli R, Trinchero R, Spodick DH, Adler Y, ICAP Investigators (2013) A randomized trial of colchicine for acute pericarditis. N Engl J Med 369:1522–1528

    Article  CAS  PubMed  Google Scholar 

  12. Imazio M, Belli R, Brucato A, Cemin R, Ferrua S, Beqaraj F, Demarie D, Ferro S, Forno D, Maestroni S, Cumetti D, Varbella F, Trinchero R, Spodick DH, Adler Y (2014) Efficacy and safety of colchicine for. treatment of multiple recurrences of pericarditis (CORP-2): a multicentre, double-blind, placebo-controlled, randomised trial. Lancet 383:2232–2237

    Article  CAS  PubMed  Google Scholar 

  13. Imazio M, Brucato A, Ferrazzi P, Pullara A, Adler Y, Barosi A, Caforio AL, Cemin R, Chirillo F, Comoglio C, Cugola D, Cumetti D, Dyrda O, Ferrua S, Finkelstein Y, Flocco R, Gandino A, Hoit B, Innocente F, Maestroni S, Musumeci F, Oh J, Pergolini A, Polizzi V, Ristic A, Simon C, Spodick DH, Tarzia V, Trimboli S, Valenti A, Belli R, Gaita F, COPPS-2 Investigators (2014) Colchicine for prevention of postpericardiotomy syndrome and postoperative atrial fibrillation: the COPPS-2 randomized clinical trial. JAMA 312:1016–1023

    Article  CAS  PubMed  Google Scholar 

  14. Meurin P, Leley-Kubas S, Pierre B, Pereira B, Iliou MC, Bussiere JL, Weber H, Beugin JP, Farrokhi T, Bellemain-Appaix A, Briota L, Tabet JY Colchicine for postoperative pericardial effusion: The Post-Operative Pericardial Effusion-2 (POPE-2) study: A multicenter, double-blind, randomized trial. European Society of Cardiology 2014 Congress; August 31, 2014; Barcelona, Spainl Hot line 889

  15. Imazio M, Spodick DH, Brucato A, Trinchero R, Adler Y (2010) Controversial issues in the management of pericardial diseases. Circulation 121:916–928

    Article  PubMed  Google Scholar 

  16. Maisch B, Seferovic PM, Ristic AD, Erbel R, Rienmuller R, Adler Y, Tomkowski WZ, Thiene G, Yacoub MH, Task Force on the Diagnosis and Management of Pricardial Diseases of the European Society of Cardiology (2004) Guidelines on the diagnosis and management of pericardial diseases executive summary; the task force on the diagnosis and management of pericardial diseases of the european society of cardiology. Eur Heart J 25:587–610

    Article  PubMed  Google Scholar 

  17. Lotrionte M, Biondi-Zoccai G, Imazio M, Castagno D, Moretti C, Abbate A, Agostoni P, Brucato AL, Di Pasquale P, Raatikka M, Sangiorgi G, Laudito A, Sheiban I, Gaita F (2010) International collaborative systematic review of controlled clinical trials on pharmacologic treatments for acute pericarditis and its recurrences. Am Heart J 160:662–670

    Article  CAS  PubMed  Google Scholar 

  18. Imazio M, Brucato A, Forno D, Ferro S, Belli R, Trinchero R, Adler Y (2012) Efficacy and safety of colchicine for pericarditis prevention. Systematic review and meta-analysis. Heart 98:1078–1082

    Article  CAS  PubMed  Google Scholar 

  19. Alabed S, Cabello JB, Irving GJ, Qintar M, Burls A (2014) Colchicine for pericarditis. Cochrane Database Syst Rev 8:CD010652. doi:10.1002/14651858.CD010652.pub2

    PubMed  Google Scholar 

  20. Imazio M, Brucato A, Belli R, Forno D, Ferro S, Trinchero R, Adler Y (2014) Colchicine for the prevention of pericarditis: what we know and what we do not know in 2014—systematic review and meta-analysis. J Cardiovasc Med 15:840–846

    Article  CAS  Google Scholar 

  21. Imazio M, Adler Y (2013) Treatment with aspirin, NSAID, corticosteroids, and colchicine in acute and recurrent pericarditis. Heart Fail Rev 18:355–360

    Article  CAS  PubMed  Google Scholar 

  22. Authors/Task Force Members, Adler Y, Charron P, Imazio M, Badano L, Barón-Esquivias G, Bogaert J, Brucato A, Gueret P, Klingel K, Lionis C, Maisch B, Mayosi B, Pavie A, Ristić AD, Sabaté Tenas M, Seferovic P, Swedberg K, Tomkowski W, Document Reviewers, Achenbach S, Agewall S, Al-Attar N, Angel Ferrer J, Arad M, Asteggiano R, Bueno H, Caforio AL, Carerj S, Ceconi C, Evangelista A, Flachskampf F, Giannakoulas G, Gielen S, Habib G, Kolh P, Lambrinou E, Lancellotti P, Lazaros G, Linhart A, Meurin P, Nieman K, Piepoli MF, Price S, Roos-Hesselink J, Roubille F, Ruschitzka F, Sagristà Sauleda J, Sousa-Uva M, Uwe Voigt J, Luis Zamorano J (2015) 2015 ESC Guidelines for the diagnosis and management of pericardial diseases: the Task Force for the Diagnosis and Management of Pericardial Diseases of the European Society of Cardiology (ESC)Endorsed by: the European Association for Cardio-Thoracic Surgery (EACTS). Eur Heart J 36:2921–2964

    Article  Google Scholar 

  23. Lilly LS (2013) Treatment of acute and recurrent idiopathic pericarditis. Circulation 127:1723–1726

    Article  PubMed  Google Scholar 

Download references

Author information

Authors and Affiliations

  1. Health Division of Guard Bureau, General staff Department of Chinese PLA, Beijing, China

    Y.-L. Li, J. Luo & H.-F. Zhang MD

  2. Department of Cardiology, The People’s Hospital of Rizhao, Rizhao, Shandong, China

    S.-B. Qiao

  3. Department of Cardiovascular Surgery, The Second People’s Hospital of Yunnan Province, Kunming, Yunnan, China

    J.-Y. Wang

  4. Department of Pediatrics, Beijing Chao-Yang Hospital, Capital Medical University, Beijing, China

    Y.-M. Chen

Authors
  1. Y.-L. Li
    View author publications

    You can also search for this author in PubMed Google Scholar

  2. S.-B. Qiao
    View author publications

    You can also search for this author in PubMed Google Scholar

  3. J.-Y. Wang
    View author publications

    You can also search for this author in PubMed Google Scholar

  4. Y.-M. Chen
    View author publications

    You can also search for this author in PubMed Google Scholar

  5. J. Luo
    View author publications

    You can also search for this author in PubMed Google Scholar

  6. H.-F. Zhang MD
    View author publications

    You can also search for this author in PubMed Google Scholar

Corresponding author

Correspondence to H.-F. Zhang MD.

Ethics declarations

Conflict of interest

Y.-L. Li, S.-B. Qiao, J.-Y. Wang, Y.-M. Chen, J. L., and H.-F. Zhang state that there are no conflicts of interest.

The accompanying manuscript does not include studies on humans or animals.

Additional information

Y.-L.Li, J.-Y.Wang, and Y.-M.Chen contributed equally to this work and should be considered co-first authors.

Rights and permissions

Reprints and permissions

About this article

Check for updates. Verify currency and authenticity via CrossMark

Cite this article

Li, YL., Qiao, SB., Wang, JY. et al. Colchicine in addition to conventional therapy for pericarditis recurrence. Herz 41, 630–638 (2016). https://doi.org/10.1007/s00059-016-4410-z

Download citation

  • Received:

  • Revised:

  • Accepted:

  • Published:

  • Issue Date:

  • DOI: https://doi.org/10.1007/s00059-016-4410-z

Keywords

Schlüsselwörter

Search

Navigation