Background
Clinical trials have evaluated the efficacy and safety of colchicine only in simple pericarditis, excluding cases of concomitant myocarditis.
Objectives
To evaluate the efficacy and safety of colchicine for the treatment of the first attack of acute pericarditis with concomitant myocardial involvement.
Methods
Double-centre retrospective cohort study, analysing consecutive patients admitted for first attack of pericarditis with myocarditis. Patients who received colchicine in addition to conventional therapy constituted the study group, while patients who received only conventional therapy constituted the control group. The primary efficacy end point was the time to the first recurrence. Propensity score matching was used to generate 2 groups of patients with similar baseline characteristics. Colchicine-associated side effects were analysed as safety end-point.
Results
A total of 175 patients (mean age 46 (SD 40) years, 25% females, 88% with idiopathic/viral etiology, 79 (45%) treated with colchicine) were included. After a median follow up of 25.3 (IQR 8.3 – 45.6) months, 58 (33%) patients had recurrences. The propensity score generated 73 pairs of patients. In this population a lower incidence of recurrence (respectively 19% vs. 45%; p=0.001) and a longer event-free survival (p=0.05) was observed among patients receiving colchicine. In multivariable analysis women (HR 2.28, 95% CI 1.23 to 4.24; p=0.009) and corticosteroid use (HR 2.17, 95% CI 1.12 to 4.19; p=0.021) were independent risk factors for recurrences. Colchicine-associated side effects were mild and occurred in 3 (2%) patients.
Conclusions
In patients with first attack of pericarditis associated with myocardial involvement, colchicine was safe and efficacious for the reduction of recurrences.
