Add-on colchicine may help prevent pericarditis recurrence

Adding colchicine to anakinra appears to work well in reducing the incidence of recurrent pericarditis, according to a study.

The study included 256 patients (mean age 45.0 years, 65.6 percent female, 80.9 percent had idiopathic/viral aetiology) who were treated with anakinra for corticosteroid-dependent and colchicine-resistant recurrent pericarditis.

Researchers performed multivariable Cox regression analyses to examine the efficacy of combining anakinra and colchicine in terms of pericarditis recurrence rate and the time to the first recurrence.

Of the patients, 64 (25.0 percent) received treatment with anakinra as monotherapy while 192 (75.0 percent) received both anakinra and colchicine.

Over 12 months of follow-up, 56 patients (21.9 percent) experienced pericarditis recurrence. Specifically, recurrence occurred while on full-dose anakinra in nine patients, during the tapering of anakinra in 36, and after anakinra discontinuation in 11.

Of note, recurrence events were fewer among patients who received anakinra plus colchicine than among those who received anakinra monotherapy (18.8 percent vs 31.3 percent; p=0.036). The event-free survival was longer in the combination treatment group (p=0.025).

Add-on colchicine was associated with an almost 50-percent reduction in the risk of pericarditis recurrence (hazard ratio, 0.52, 95 percent confidence interval, 0.29–0.91; p=0.021).

The findings underscore the possibility that the sequential block of the inflammatory pathway generating IL-1 by two drugs (colchicine and anakinra) could be more efficacious.