Efficacy and safety of colchicine for pericarditis prevention. Systematic review and meta-analysis
Evidence Based Medicine
Imazio M et al. – Available evidence suggests that colchicine is safe and efficacious for the primary and secondary prevention of pericarditis.Methods
- Controlled clinical studies were searched in several databases and were included provided they focused on the pharmacologic primary or secondary prevention of pericarditis.
- Authors performed a meta–analysis including studies primary outcome, adverse events, and drug withdrawal.
- From the initial sample of 127 citations, five controlled clinical trials were finally included (795 patients): three studies were double–blind randomised controlled trials, and two studies were open–label randomised controlled trials.
- Trials followed patients for a mean of 13 months.
- Meta–analytic pooling showed that colchicine use was associated with a reduced risk of pericarditis during follow–up (RR=0.40, 95% CI 0.30 to 0.54, p for effect <0.001, p for heterogeneity = 0.95, I2=0%) either for primary or secondary prevention without a significant higher risk of adverse events compared with placebo (RR=1.22, 95% CI 0.71 to 2.10, p for effect 0.48, p for heterogeneity = 0.44, I2=0%), but more cases of drug withdrawals (RR=1.85, 95% CI 1.04 to 3.29, p for effect 0.04, p for heterogeneity = 0.42, I2=0%).
- Gastrointestinal intolerance is the most frequent side effect (mean incidence 8%), but no severe adverse events were recorded.