Although colchicine has been shown to be beneficial in patients with recurrent pericarditis, which is thought to have a large inflammatory component related to an immune response, until now its efficacy in a first episode of acute pericarditis has been uncertain, as these episodes are thought\u00a0to usually have a viral component that might benefit from an inflammatory response.<\/p>\n
In a study published in the\u00a0New England Journal of Medicine<\/em><\/a>,\u00a0240 patients with acute pericarditis and\u00a0receiving conventional therapy with aspirin or ibuprofen\u00a0were randomized to colchicine or placebo for 3 months.\u00a0Colchicine was found effective in reducing the rate of incessant or recurrent pericarditis (the primary outcome of the trial), as well as symptom recurrence at 72 hours, the number of recurrences per patient, and the rate of hospitalization:<\/p>\n There were no significant differences in adverse effects or discontinuation of the study drugs.<\/p>\n Results of the study\u00a0confirm current European guidelines, which give a class IIa indication for the use of colchicine in acute pericarditis, and an earlier, single-center, open-label\u00a0trial<\/a>. The precise mechanism of action of colchicine is uncertain, though the authors point to its high concentration in leukocytes. They conclude\u00a0that “colchicine, when added to conventional antiinflammatory therapy, significantly reduced the rate of incessant or recurrent pericarditis” in patients with a first episode of acute pericarditis.<\/p>\n\n