In a new trial (Lancet March 30, 2014), colchicine, was found to be safe and beneficial adjunct to nonsteroidal anti-inflammatory drugs, even in patients with multiple recurrences. Previous trials have demonstrated the efficacy and safety of colchicine as an adjunct to conventional treatment in patients with acute pericarditis or first recurrences.
To assess whether colchicine’s effectiveness extends to multiple recurrences, investigators in Italy conducted the multicenter, double-blind, CORP-2 trial. They randomly assigned 240 patients with ≥ 2 recurrences of pericarditis to receive placebo or 0.5 mg colchicine (twice daily in patients heavier than 70 kg; once daily in those ≤70 kg) for 6 months. All participants also received nonsteroidal anti-inflammatory drugs (NSAIDs) or corticosteroids. During a mean follow-up of 20 months, the rate of pericarditis recurrence was about half as high in the colchicine group as in the placebo group (21.6% vs. 42.5%; P<0.001), and the rate of remission at 1 week of treatment was significantly higher in the colchicine group (83.3% vs. 59.2%). Rates of adverse events and drug discontinuation were low and similar in both groups.
These findings suppot the evidence that colchicine is a safe and effective adjunct to NSAIDs for the treatment of pericarditis.
Imazio M et al. for the ICAP Investigators. A randomized trial of colchicine for acute pericarditis. N Engl J Med 2013 Sep 1; [e-pub].
Imazio M et al. Efficacy and safety of colchicine for treatment of multiple recurrences of pericarditis (CORP-2): A multicentre, double-blind, placebo-controlled, randomised trial. Lancet 2014 Mar 30; [e-pub].