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Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome
BACKGROUND: Colchicine has been used as anti-inflammatory agent in pericardial effusion (PE). We sought to perform a meta-analysis of randomized trials assessing the efficacy and safety of colchicine in patients with pericarditis or postpericardiotomy syndrome (PPS). METHODS: In the systematic liter...
Autores principales: | , , , , , , |
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Formato: | Online Artículo Texto |
Lenguaje: | English |
Publicado: |
BioMed Central
2019
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Materias: | |
Acceso en línea: | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720402/ https://www.ncbi.nlm.nih.gov/pubmed/31477020 http://dx.doi.org/10.1186/s12872-019-1190-4 |
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author | Lutschinger, Leon L. Rigopoulos, Angelos G. Schlattmann, Peter Matiakis, Marios Sedding, Daniel Schulze, Christian Noutsias, Michel |
author_facet | Lutschinger, Leon L. Rigopoulos, Angelos G. Schlattmann, Peter Matiakis, Marios Sedding, Daniel Schulze, Christian Noutsias, Michel |
author_sort | Lutschinger, Leon L. |
collection | PubMed |
description | BACKGROUND: Colchicine has been used as anti-inflammatory agent in pericardial effusion (PE). We sought to perform a meta-analysis of randomized trials assessing the efficacy and safety of colchicine in patients with pericarditis or postpericardiotomy syndrome (PPS). METHODS: In the systematic literature search following the PRISMA statement, 10 prospective randomized controlled studies with 1981 patients with an average follow-up duration of 13.6 months were identified. RESULTS: Colchicine reduced the recurrence rate of pericarditis in patients with acute and recurrent pericarditis and reduced the incidence of PPS (RR: 0.57, 95% CI: 0.44–0.74). Additionally, the rate of rehospitalizations as well as the symptom duration after 72 h was significantly decreased in pericarditis (RR 0.33; 95% CI 0.18–0.60; and RR 0.43; 95% CI 0.34–0.54; respectively), but not in PPS. Treatment with colchicine was associated with significantly higher adverse event (AE) rates (RR 1.42; 95% CI 1.05–1.92), with gastrointestinal intolerance being the leading AE. The reported number needed to treat (NNT) for the prevention of recurrent pericarditis ranged between 3 and 5. The reported NNT for PPS prevention was 10, and the number needed to harm (NNH) was 12, respectively. Late colchicine administration > 7 days after heart surgery did not reduce postoperative PE. CONCLUSIONS: Our meta-analysis confirms that colchicine is efficacious and safe for prevention of recurrent pericarditis and PPS, while it reduces rehospitalizations and symptom duration in pericarditis. The clinical use of colchicine for the setting of PPS and postoperative PE after heart surgery should be investigated in further multicenter RCT. |
format | Online Article Text |
id | pubmed-6720402 |
institution | National Center for Biotechnology Information |
language | English |
publishDate | 2019 |
publisher | BioMed Central |
record_format | MEDLINE/PubMed |
spelling | pubmed-67204022019-09-06 Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome Lutschinger, Leon L. Rigopoulos, Angelos G. Schlattmann, Peter Matiakis, Marios Sedding, Daniel Schulze, Christian Noutsias, Michel BMC Cardiovasc Disord Research Article BACKGROUND: Colchicine has been used as anti-inflammatory agent in pericardial effusion (PE). We sought to perform a meta-analysis of randomized trials assessing the efficacy and safety of colchicine in patients with pericarditis or postpericardiotomy syndrome (PPS). METHODS: In the systematic literature search following the PRISMA statement, 10 prospective randomized controlled studies with 1981 patients with an average follow-up duration of 13.6 months were identified. RESULTS: Colchicine reduced the recurrence rate of pericarditis in patients with acute and recurrent pericarditis and reduced the incidence of PPS (RR: 0.57, 95% CI: 0.44–0.74). Additionally, the rate of rehospitalizations as well as the symptom duration after 72 h was significantly decreased in pericarditis (RR 0.33; 95% CI 0.18–0.60; and RR 0.43; 95% CI 0.34–0.54; respectively), but not in PPS. Treatment with colchicine was associated with significantly higher adverse event (AE) rates (RR 1.42; 95% CI 1.05–1.92), with gastrointestinal intolerance being the leading AE. The reported number needed to treat (NNT) for the prevention of recurrent pericarditis ranged between 3 and 5. The reported NNT for PPS prevention was 10, and the number needed to harm (NNH) was 12, respectively. Late colchicine administration > 7 days after heart surgery did not reduce postoperative PE. CONCLUSIONS: Our meta-analysis confirms that colchicine is efficacious and safe for prevention of recurrent pericarditis and PPS, while it reduces rehospitalizations and symptom duration in pericarditis. The clinical use of colchicine for the setting of PPS and postoperative PE after heart surgery should be investigated in further multicenter RCT. BioMed Central 2019-09-02 /pmc/articles/PMC6720402/ /pubmed/31477020 http://dx.doi.org/10.1186/s12872-019-1190-4 Text en © The Author(s). 2019 Open AccessThis article is distributed under the terms of the Creative Commons Attribution 4.0 International License (http://creativecommons.org/licenses/by/4.0/), which permits unrestricted use, distribution, and reproduction in any medium, provided you give appropriate credit to the original author(s) and the source, provide a link to the Creative Commons license, and indicate if changes were made. The Creative Commons Public Domain Dedication waiver (http://creativecommons.org/publicdomain/zero/1.0/) applies to the data made available in this article, unless otherwise stated. |
spellingShingle | Research Article Lutschinger, Leon L. Rigopoulos, Angelos G. Schlattmann, Peter Matiakis, Marios Sedding, Daniel Schulze, Christian Noutsias, Michel Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title | Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title_full | Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title_fullStr | Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title_full_unstemmed | Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title_short | Meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
title_sort | meta-analysis for the value of colchicine for the therapy of pericarditis and of postpericardiotomy syndrome |
topic | Research Article |
url | https://www.ncbi.nlm.nih.gov/pmc/articles/PMC6720402/ https://www.ncbi.nlm.nih.gov/pubmed/31477020 http://dx.doi.org/10.1186/s12872-019-1190-4 |
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