The Safety and Efficacy of Colchicine for the Treatment of Pericarditis

摘要

BACKGROUND: Colchicine has been traditionally used for the treatment of gout. In just over the last twenty years, colchicine has been gaining interest as a treatment for acute and recurrent pericarditis. A few small studies have addressed the safety and efficacy of this treatment, however, a general agreement has not been reached.METHODS: A systematic literature review of the studies focusing on colchicine for the treatment of pericarditis, from 1990 to present, was performed using the MEDLINE, CINAHL and Web of Science databases. A modified validity scoring method (0-10) was applied to the studies that qualified through the inclusion and exclusion criteria.RESULTS: Five studies that focused on colchicine for the treatment of pericarditis met the inclusion and exclusion criteria. There were two randomized, open-label studies (n=120 u26 n=84) with a validity score of eight. There was one prospective, cohort study (n=58) with a validity score of five. There was one retrospective, multi-center case analysis (n=119) that received a validity score of two, and a prospective case series (n=9) with a validity score of three. All of the studies found colchicine to be effective for the treatment of acute or recurrent pericarditis, with 1 mg daily as the most common dose. There were no reports of serious, adverse reactions to colchicine. Diarrhea was the most common side effect. As a secondary outcome, corticosteroids were found to be an independent risk factor for the recurrence of pericarditis in three of the studies.CONCLUSION: Based on this systematic review of literature, there is moderate evidence showing colchicine to be safe and effective in the treatment of acute or recurrent pericarditis. However, a larger, double-blinded, randomized-controlled trial is needed to further investigate this potential treatment. There is also some evidence to support corticosteroids as an independent risk factor for the recurrence of pericarditis.