Colchicine in addition to conventional therapy for pericarditis recurrence : An update meta-analysis.

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.