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Colchicine treatment for recurrent pericarditis (CORP): a randomized trial.

Author(s): Imazio M, Antonio B, Roberto C, Ferrua S, Belli R, Maestroni S, Trinchero R, Spodick DH, Adle Y

Affiliation(s): Cardiology Department,Maria Vittoria Hospital, Torino, Italy. massimo_imazio@yahoo.it

Publication date & source: 2011-10-04, Ann Intern Med., 155(7):I28. Epub 2011 Aug 28.

Publication type: Research Support, Non-U.S. Gov't

BACKGROUND: Recurrence is the most common complication of pericarditis,affecting 10% to 50% of patients. OBJECTIVE: To evaluate the efficacy and safety of colchicine for the secondary prevention of recurrent pericarditis. DESIGN: Prospective, randomized, double-blind, placebo controlled multicenter trial. (ClinicalTrials.gov registration number:NCT00128414) SETTING: 4 general hospitals in urban areas of Italy. PATIENTS: 120 patients with a first recurrence of pericarditis.Intervention: In addition to conventional treatment, patients were randomly assigned to receive either placebo or colchicine, 1.0 to 2.0 mg on the first day followed by a maintenance dose of 0.5 to1.0 mg/d, for 6 months. MEASUREMENTS: The primary study end point was the recurrence rate at 18 months. Secondary end points were symptom persistenceat 72 hours, remission rate at 1 week, number of recurrences,time to first recurrence, disease-related hospitalization, cardiac tamponade,and rate of constrictive pericarditis. RESULTS: At 18 months, the recurrence rate was 24% in the colchicine group and 55% in the placebo group (absolute risk reduction,0.31 [95% CI, 0.13 to 0.46]; relative risk reduction, 0.56 [CI,0.27 to 0.73]; number needed to treat, 3 [CI, 2 to 7]). Colchicine reduced the persistence of symptoms at 72 hours (absolute risk reduction, 0.30 [CI, 0.13 to 0.45]; relative risk reduction, 0.56 [CI,0.27 to 0.74]) and mean number of recurrences, increased there mission rate at 1 week, and prolonged the time to subsequent recurrence. The study groups had similar rates of side effects and drug withdrawal. LIMITATION: Multiple recurrences and neoplastic or bacterial causes were excluded. CONCLUSION: Colchicine is safe and effective for secondary prevention of recurrent pericarditis.

Page last updated: 2011-12-09

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