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CORP-2: Colchicine helped reduce recurrence of pericarditis
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WASHINGTON — When added to conventional anti-inflammatory treatment, colchicine reduced the rate of recurrent pericarditis in patients with multiple recurrences, according to findings presented at the American College of Cardiology Scientific Sessions.
Massimo Imazio, MD, and colleagues enrolled 240 patients (mean age, 48 years; 50% men) with at least two recurrences of pericarditis in the double blind CORP-2 study. All patients received conventional anti-inflammatory treatment of aspirin, ibuprofen or indometacin. Half were randomly assigned colchicine, 0.5 mg twice daily for patients weighing >70 kg and 0.5 mg once daily for those weighing ≤70 kg, and the other half to placebo. Colchicine and placebo were administered for 6 months.
The primary outcome was recurrent pericarditis in the intention-to-treat population at 18 months.
Massimo Imazio
Imazio, of Maria Vittoria Hospital, Turin, Italy, said at a press conference that he and his colleagues found that 21.6% of patients in the colchicine group had recurrent pericarditis compared with 42.5% in the placebo group (RR=0.49; 95% CI, 0.24-0.65; number needed to treat, 5).
The colchicine group also had favorable results compared with the placebo group in the following outcomes:
- Symptom persistence at 72 hours (placebo, 44.2% vs. colchicine, 19.2%; P=.0001);
- Number of recurrences per patient (placebo, 0.63 vs. colchicine, 0.28; P=.0004);
- Pericarditis-related hospital admission (placebo, 10% vs. colchicine, 1.7%; P=.013).
There were no serious adverse events, which occurred at a similar rate in the two groups. The most common adverse event was gastrointestinal intolerance, according to Imazio.
“The safety profile is reassuring,” he said. “The gastrointestinal intolerance can also be caused by several other drugs that these patients were using.
“Taking all the data together, we have evidence that colchicine is really able to reduce the incidence of pericarditis,” Imazio said. “This is a very safe and efficacious drug. Colchicine should be properly regarded as a first-line treatment for acute or recurring pericarditis in the absence of contraindications.” – by Erik Swain
For more information:
Imazio M. Late-Breaking Clinical Trials III. Presented at: American College of Cardiology Scientific Sessions; March 29-31, 2014; Washington, D.C.
Imazio M. Lancet. 2014;doi:10.1016/S0140-6736(13)62709-9.
Disclosure: Acarpia provided the study drug and placebo. Imazio reports no relevant financial disclosures.
Perspective
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Prediman K. Shah, MD, FACC
This colchicine study reemphasizes what we’ve known for a few years: Colchicine is an effective and safe drug for not only an initial episode of pericarditis, but also for recurrent episodes of pericarditis. This study reestablishes its value in that setting, with a very acceptable side-effect profile.
The only problem is that in the United States, manufacturers have raised the price of colchicine to ridiculous levels, and that’s a crying shame.
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