Anti-inflammatory treatment is the mainstay of therapy for pericarditis. Aspirin, NSAIDs, steroids – and now, colchicine. Used to treat inflammation related to gouty attacks, useful in other types of serositis, colchicine has been suggested as having value in pericarditis, as well.
This is a seven-year double-blind, randomized controlled trial between colchicine and placebo, added to usual therapy – which, in this case, was usually aspirin. Primary outcome was “incessant or recurrent pericarditis” – and, there’s no doubt in this trial the colchicine is successful and mostly harmless. With standard anti-inflammatory treatment 37% of patients suffered incessant or recurrent pericarditis within the 18-month follow-up period, compared with 16.7% of patients receiving colchicine. Colchicine had beneficial effect on symptom persistence at 72 hours – 40.0% vs. 19.2% – and was superior with remission at one week – 58.3% vs. 85.0%.
Adverse effects and drug discontinuation rates were essentially identical within the bounds of their relatively small sample size. I don’t see any particular reason to exclude appropriate patients from colchicine for acute pericarditis.
“A Randomized Trial of Colchicine for Acute Pericarditis”
http://www.ncbi.nlm.nih.gov/pubmed/23992557