ICAP

Investigation on Colchicine for Acute Pericarditis

Patient / Population Intervention / Exposure Comparison Outcome

In 240 patients with a first episode of acute pericarditis, colchicine added to conventional anti-inflammatory therapy reduced incessant or recurrent pericarditis compared with placebo.

240

Design

Double-blind, placebo-controlled RCT

Endpoint

Incessant or recurrent pericarditis

Relevance

Result16.7 % vs 37.5 % (relative risk reduction 0.56; 95 % CI 0.30–0.72; NNT 4; p<0.001). Remission at 1 week 85.0 % vs 58.3 %. Adverse events comparable.

Imazio M, Brucato A, Cemin R, et al. N Engl J Med. 2013;369(16):1522-1528. 10.1056/NEJMoa1208536

Discussion & critique

Modest in size, Italian centres only, and bacterial and neoplastic aetiologies were excluded, so the effect applies to idiopathic or viral pericarditis. It converted colchicine from a rescue drug into routine first-line adjunctive therapy from the first attack onwards.