Efficacy of colchicine in recurrent acute idiopathic pericarditis.

Acute idiopathic pericarditis is complicated by recurrence in 15 to 30% of cases. The preventive treatment of recurrences is not well codified. Aspiri n, non-steroidal anti-inflammatory drugs and corticoids are the commonest p rescribed treatments. The objective of this study was to assess the value o f colchicine in the prevention of recurrences of acute idiopathic pericardi tis. Twenty-eight cases of recurrent acute pericarditis (2 episodes, 1 month bet ween each episode) admitted to a department of internal medicine between 19 89 and 1999 were reviewed. Analysis was concentrated on the 13 idiopathic f orms. The subjects were 7 women and 6 men with an average age of 41 years ( 10-62) at the time of the first episode of acute pericarditis. These 13 pat ients were treated with colchicine (1 to 2 mg/day) after failure of convent ional treatment (aspirin 13/13, NSAID 13/13, steroids 9/13 and pericardioce ntesis 3/13). Ten patients were followed up regularly (6 months after start ing colchicine) and were improved with respect to number, duration and inte nsity of their recurrences. The average duration of colchicine therapy was 17 +/- 14 months (6-48). Progressive withdrawal of NSAID and steroids was o btained in 8/10 cases. The authors conclude that colchicine is useful in the prevention of recurre nce of acute pericarditis. It may be proposed as treatment of choice, espec ially in the idiopathic forms.