The Role of Colchicine in Pericardial Syndromes

Author:

Lazaros George1,Imazio Massimo2,Brucato Antonio3,Vlachopoulos Charalambos1,Lazarou Emilia1,Vassilopoulos Dimitrios4,Tousoulis Dimitris1

Affiliation:

1. First Cardiology Department, Hippokration General Hospital, National and Kapodistrian University of Athens, Athens, Greece

2. University Cardiology, AOU Citta della Salute e della Scienza di Torino, Torino 10126, Italy

3. Internal Medicine and Rheumatology, Ospedale Papa Giovanni XXIII, Bergamo, Italy

4. Joint Rheumatology Program, Clinical Immunology-Rheumatology Unit, 2nd Department of Medicine and Laboratory, School of Medicine, National and Kapodistrian University of Athens, Hippokration General Hospital, Athens, Greece

Abstract

Background: Colchicine is an old drug originally employed for the treatment of inflammatory disorders such as acute gout and familiar Mediterranean fever. Methods: In the past few decades, colchicine has been at the forefront of the pharmacotherapy of several cardiac diseases, including acute and recurrent pericarditis, coronary artery disease, prevention of atrial fibrillation and heart failure. In this review, we have summarized the current evidence based medicine and guidelines recommendations in the specific context of pericardial syndromes. Results: Colchicine has been firstly engaged in the treatment of recurrent pericarditis of viral, idiopathic and autoimmune origin. Shortly thereafter colchicine use has been expanded to the primary prevention of recurrences in patients with a first episode of pericarditis depicting similarly good results. The acquisition of high quality scientific data in the course of time from prospective randomized placebo-controlled trials and metanalyses have established colchicine as first line treatment option in acute and recurrent pericarditis, on top of the conventional treatment. The only concerns related to the use of colchicine are the side effects (mainly gastrointestinal intolerance) which although generally not serious, may account for treatment withdrawal in some cases. Conclusion: Colchicine has been established as a first line medication in the treatment of acute (first episode) and recurrent pericarditis on top of the conventional treatment as well as for the prevention of postpericardiotomy syndrome. It depicts a good safety profile with gastrointestinal intolerance being the most common side effect.

Publisher

Bentham Science Publishers Ltd.

Subject

Drug Discovery,Pharmacology

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1. The Role of Inflammasomes in Heart Failure;International Journal of Molecular Sciences;2024-05-14

2. The effect of colchicine on cholesterol crystal formation, expansion and morphology: a potential mechanism in atherosclerosis;Frontiers in Cardiovascular Medicine;2024-02-16

3. Network Pharmacology Analysis of the Therapeutic Potential of Colchicine in Acute Lung Injury;International Journal of Clinical Practice;2024-02-06

4. Colchicine and plaque: A focus on atherosclerosis imaging;Progress in Cardiovascular Diseases;2024-02

5. Colchicine for the primary prevention of cardiovascular events;Cochrane Database of Systematic Reviews;2022-06-28

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