Colchicine on par with NSAID for pericarditis prevention in HFrEF, CAD

The incidence of pericarditis recurrence or documentation of incessant symptoms within 12 months of the index hospitalization does not differ between heart failure (HF) patients treated with colchicine monotherapy and those who received NSAID monotherapy.

This single health-system, retrospective, observational cohort study included 77 adult patients diagnosed with acute pericarditis and HF with reduced ejection fraction (HFrEF) or coronary artery disease (CAD) and were discharged on colchicine and/or NSAID therapy. Those with an episode of pericarditis within the previous 12 months were excluded.

Of the patients, 43 (55.8 percent) received colchicine monotherapy, seven (9.1 percent) received NSAID monotherapy, and 27 (35.1 percent) were treated with combination therapy.

Pericarditis recurred or documentation of incessant symptoms occurred in 16.3 percent of patients on colchicine monotherapy, 28.6 percent of those on NSAID monotherapy, and 18.5 percent of those on combination therapy (p=0.740).

Although no significant between-group difference was observed, the investigators suggested further randomized trials to explore the efficacy of colchicine monotherapy for the treatment of acute pericarditis in patients with HFrEF or CAD.

“Guidelines recommend NSAIDs or aspirin for 2 to 4 weeks with colchicine for 3 months for the treatment of acute pericarditis,” according to the investigators. “In patients with HFrEF and/or CAD, the adverse effect profile of NSAIDs poses concern.”