Colchicine beneficial in treatment of myopericarditis

In patients who have had a first attack of pericarditis with evidence of myocardial involvement, treatment with colchicine is safe and helps reduce the risk of recurrence, according to a study.

The study included 175 consecutive patients (mean age 46.2 years, 25.1 percent women, 88.6 percent had idiopathic/viral aetiology) who were admitted for first attack of pericarditis with myocarditis. Of these patients, 79 (45.1 percent) received treatment with colchicine.

Propensity score matching was applied to generate two groups of patients with similar baseline characteristics. The primary endpoint was the time to first recurrence. Side effects were also identified as a safety endpoint.

Over a median follow-up of 25.3 months, recurrence occurred in 58 patients (33.1 percent). Propensity score matching yielded 73 patients each in the colchicine-exposed group and the control group.

Compared with those in the control group, patients in the colchicine-exposed group were less likely to experience recurrence (19.2 percent vs 43.8 percent; p=0.001) and a longer event-free survival (p=0.005).

Multivariable analysis showed that the risk of recurrence was high among women (hazard ratio [HR], 1.97, 95 percent confidence interval [CI], 1.04–3.73; p=0.037) and those who used corticosteroids (HR, 2.27, 95 percent CI, 1.15–4.47; p=0.018).

In terms of safety, colchicine-related side effects were mild and documented in three patients (1.7 percent).