TREATMENT OF RECURRENT PERICARDITIS WITH COLCHICINE

Corticosteroid therapy, because of its frequent and severe side effects should be avoided if possible, and colchicine may be an effective substitute in steroid-dependent recurrent pericarditis.The aim of our study was to assess the usefulness of colchicine in recurrent pericarditis before initiating corticosteroid treatment. Nineteen consecutive patients (10 males, nine females, age 46±7 years) with recurrent pericarditis (two episodes or more) were included in this prospective open-label study. Before the study, the patients suffered a total of 57 episodes of pericarditis (mean=3·0 ± 0·5 episodes. patient-1) despite the use of non-steroidal anti-inflammatory drugs. The mean interval time between the episodes was 7·3±5·3 months. Colchicine was given at a loading dose of 3 mg and a maintenance dose of 1 mg daily (for 1 to 27 months (mean=7·7). During the clinical follow-up, the efficacy was estimated by the occurrence of new episodes of pericarditis and by the need for corticosteroid treatment. No recurrence occurred in 14 out of the 19 patients (74%) during a follow-up of 37·4±6·5 months. In four out of the 19 patients (21%), five recurrences occurred, which resolved without corticosteroids. Follow-up at 23·8±12·7 months was free of further recurrence. Only one patient (5%) had several recurrences and required corticosteroids for chronic rheumatism. Tolerance was good except for two cases of diarrhoea, one case of hypothyroidism due to associated long-term antidiarrhoeal therapy (containing iodine), and one case of mild leucopenia. No side effects required interruption of treatment, and the overall duration of recurrence-free follow-up after treatment with colchicine (32·5±6·9 months) was significantly different from the mean interval time between the different episodes before colchicine (P<0·0001). Thus, colchicine offered a very good benefit/risk ratio in our patients with recurrent pericarditis and could avoid the need for corticosteroid treatment. © 1994 The European Society of Cardiology.