From the Department of Cardiology, Rabin Medical Center, Department of
Pediatrics C, Schneider Children's Medical Center of Israel, Beilinson
Campus, Petah Tiqva, and Sackler Faculty of Medicine, Tel Aviv University, Tel
Aviv, Israel (Y.A., Y.F., A.S.); the Department of Cardiology and Rheumatic
Diseases, Hospital de Sant Pau, Barcelona, Spain (J.G., A.R.d.l.S., A.B.-G.,
A.B.d.L.); the Department of Internal Medicine B, Sheba Medical Center, Tel
Hashomer, Israel (Y.S.); and the Division of Cardiology, St Vincent Hospital,
Worcester, Mass (D.H.S.).
Correspondence to Y. Adler, MD, Department of Cardiology, Rabin Medical Center, Beilinson Campus, Petah Tiqva, 49100, Israel.
Background—The most troublesome
complication of acute pericarditis is recurrent episodes of pericardial
inflammation, occurring in 15% to 32% of cases. The cause of the
recurrence is usually unknown, although in some cases it may be
traced to viral infection or may be a consequence of coronary
artery bypass grafting. The optimal method for prevention has not been
fully established; accepted modalities include nonsteroidal
anti-inflammatory drugs, corticosteroids,
immunosuppressive agents, and pericardiectomy.
Methods and Results—Based on the proven efficacy of colchicine
therapy for familial Mediterranean fever (recurrent polyserositis),
several small studies have used colchicine successfully to prevent
recurrence of acute pericarditis after failure of conventional
treatment. Recently, we reported the results from the largest
multicenter international study on 51 patients who were treated with
colchicine to prevent further relapses and who were followed up for
Conclusions—In light of new trial data that have accumulated in
the past decade, we review the evidence for the efficacy and safety of
colchicine for the prevention of recurrent episodes of pericarditis.
Clinical and personal experience shows that colchicine may be an
extremely promising adjunct to conventional treatment and may
ultimately serve as the initial mode of treatment, especially in
idiopathic cases.
© 1998 American Heart Association, Inc.
Current Perspectives
Colchicine Treatment for Recurrent Pericarditis
A Decade of Experience
10 years.
Key Words: pericarditis • colchicine
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