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

Abstract

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. Studies were retrieved from PubMed, the Cochrane Library, and the EMBASE database. We identified nine RCTs with 1832patients and a mean follow-up of 13.1months. Overall, colchicine therapy significantly decreased the risk of pericarditis recurrence (odds ratio, OR 0.42; 95 % confidence interval, CI0.33-0.52; 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 72h. 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. 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.