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Herz

, Volume 41, Issue 7, pp 630–638 | Cite as

Colchicine in addition to conventional therapy for pericarditis recurrence

An update meta-analysis
  • Y.-L. Li
  • S.-B. Qiao
  • J.-Y. Wang
  • Y.-M. Chen
  • J. Luo
  • H.-F. Zhang
Original articles

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.

Keywords

Randomized controlled trials Post-pericardiotomy syndrome Recurrence Prednisone Adverse event 

Colchicin zusätzlich zur konventionellen Therapie bei Perikarditisrezidiv

Eine aktualisierte Metaanalyse

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.

Schlüsselwörter

Randomisierte kontrollierte Studien Postperikardiotomiesyndrom Rezidiv Prednison Unerwünschtes Ereignis 

Notes

Compliance with ethical guidelines

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.

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Copyright information

© Springer Medizin Verlag 2016

Authors and Affiliations

  • Y.-L. Li
    • 1
  • S.-B. Qiao
    • 2
  • J.-Y. Wang
    • 3
  • Y.-M. Chen
    • 4
  • J. Luo
    • 1
  • H.-F. Zhang
    • 1
  1. 1.Health Division of Guard Bureau, General staff Department of Chinese PLABeijingChina
  2. 2.Department of CardiologyThe People’s Hospital of RizhaoRizhaoChina
  3. 3.Department of Cardiovascular SurgeryThe Second People’s Hospital of Yunnan ProvinceKunmingChina
  4. 4.Department of PediatricsBeijing Chao-Yang Hospital, Capital Medical UniversityBeijingChina

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