Does colchicine decrease the rate of recurrence of acute idiopathic pericarditis treated with glucocorticoids?
| Autor: | Chava Chezar Azzerad, Zaza Iakobishvili, Ran Kornowski, Aviv Mager, Yeela Talmor, Avital Porter, David Hasdai |
|---|---|
| Rok vydání: | 2018 |
| Předmět: |
Adult
Male medicine.medical_specialty Adolescent 030204 cardiovascular system & hematology Gastroenterology Cohort Studies Young Adult 03 medical and health sciences chemistry.chemical_compound Pericarditis 0302 clinical medicine Acute pericarditis Recurrence Prednisone Internal medicine medicine Humans Colchicine In patient 030212 general & internal medicine Glucocorticoids Aged Retrospective Studies Aged 80 and over Aspirin business.industry Anti-Inflammatory Agents Non-Steroidal Length of Stay Middle Aged medicine.disease Treatment Outcome chemistry Acute Disease Cohort Cardiology Drug Therapy Combination Female Acute idiopathic pericarditis Cardiology and Cardiovascular Medicine business medicine.drug |
| Zdroj: | Journal of Cardiology. 71:409-413 |
| ISSN: | 0914-5087 |
| DOI: | 10.1016/j.jjcc.2017.10.005 |
| Popis: | Background The traditional treatment of acute pericarditis includes non-steroidal anti-inflammatory agents (NSAIDs) or glucocorticoids. The addition of colchicine has been found to reduce the rate of recurrences. Glucocorticoids, however, may attenuate this effect, although the available data are limited. We examined the impact of colchicine on the rate of recurrence of acute idiopathic pericarditis pretreated with prednisone. Methods The frequency of recurrence in patients hospitalized for acute idiopathic pericarditis in a tertiary medical center in 2004–2014 who were treated with glucocorticoids or with non-steroidal therapy was assessed from the computerized hospital database. A retrospective design was used. Results The cohort included 199 patients aged 18–86 years. Sixty-two (31%) were treated with prednisone, 42 with colchicine and 20 without, and 133 with non-steroidal therapy; in 4 patients, therapy was not detailed. Follow-up ranged from 13 to 147 months (median, 48 months). Fifty-three patients (26.6%) experienced at least one recurrence of pericarditis. The recurrence rate was significantly higher in patients who received prednisone and colchicine (17/42, 40.5%) than in patients who received NSAIDs or aspirin and colchicine (8/44, 18.2%, p = 0.03) or any non-steroidal therapy (30/133, 22.6%, p = 0.03). There was no difference between the rate of recurrence in patients who were treated with prednisone alone (5/20, 25%) and those treated with NSAIDs or aspirin and colchicine or with any non-steroidal therapy (p = NS). Baseline characteristics and duration of follow-up were similar in patients with and without recurrence. Hospital stay was longer in patients treated with prednisone alone as compared to patients treated with prednisone and colchicine. There were no other differences in baseline characteristics between these groups. Conclusions The addition of colchicine to prednisone in patients admitted for acute idiopathic pericarditis does not reduce the risk of recurrence. This finding suggests that prednisone blunts the salutary effects of colchicine. |
| Databáze: | OpenAIRE |
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