The Role of Colchicine in Recent Clinical Trials - A Focused Review on Pericardial Disease
American College of Cardiology
Aug 13, 2020 | Nadia Bouabdallaoui, MD, PHD; Jean Claude Tardif, MD, FACCExpert Analysis
Note- after first episode colchicine used for 3 or 6 months, but reporting outcome to 18 months
ICAP. A Randomized Trial of Colchicine for Acute Pericarditis, NEJM
Colchicine in pericarditis
Recent clinical trials have demonstrated that colchicine is effective in reducing symptoms and recurrence rates in patients with pericarditis, making it a recommended treatment option.
Key Clinical Trials Involving Colchicine for Pericarditis
COPE Trial:
The COPE (COlchicine for acute PEricarditis) trial showed that colchicine, when added to conventional anti-inflammatory therapy, significantly reduced symptoms at 72 hours (11.7% vs. 36.7%; p=0.003) and recurrence rates at 18 months (10.7% vs. 32.3%; p=0.004).
ICAP Trial: The ICAP (Investigation on Colchicine for Acute Pericarditis) trial found that colchicine reduced the risk of recurrent pericarditis at 18 months compared to placebo (16.7% vs. 37.5%, P<0.001). It also decreased symptom persistence at 72 hours (19.2% vs. 40.0%, p=0.001) and hospitalization rates (5.0% vs. 14.2%, p=0.02).
CORE Trial:
The CORE (COlchicine for REcurrent Pericarditis) study indicated that adding colchicine to aspirin therapy significantly reduced recurrence rates at 18 months (24.0% vs. 50.6%; p=0.02).
CORP Study:
The CORP (Colchicine for Recurrent Pericarditis) study confirmed that colchicine combined with NSAIDs led to a significant reduction in recurrent events compared to NSAIDs alone (relative risk reduction of 0.56).
COPPS Study:
The COPPS (COlchicine for the Prevention of the Post-pericardiotomy Syndrome) trial demonstrated that colchicine therapy significantly reduced the incidence of post-pericardiotomy syndrome at 12 months compared to placebo (8.9% vs. 21.1%; p=0.002).
Conclusion
Colchicine has emerged as a first-line therapy for both acute and recurrent pericarditis, showing significant benefits in reducing symptoms and recurrence rates. The European Society of Cardiology now recommends colchicine as an adjunct to conventional anti-inflammatory therapy for managing pericarditis, highlighting its effectiveness based on recent clinical trial data.
ref: 2025081103