title: Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multi-centre all-case analysis.
abstract: OBJECTIVE
  Effective prevention of recurrent pericarditis remains an important yet elusive goal. Corticosteroid therapy often needs to be continued for a prolonged period and causes severe side effects. We performed a multi-centre all-case analysis to investigate the efficacy of colchicine in preventing subsequent relapses of pericarditis, and addressed the hypothesis that pretreatment with corticosteroids may attenuate the beneficial effect of colchicine.
  
  
  RESULTS
  One hundred and forty published and unpublished cases of patients treated with colchicine after at least two relapses of pericarditis were aggregated from European centres. Of those, 119 were included in the study group. Only 18% of the patients had relapses under colchicine therapy, and 30% after its discontinuation. There were significantly more relapses among male patients after colchicine treatment (36 vs. 17%, P=0.046), and those with previous corticosteroid treatment (43 vs. 13%, P=0.02). Multivariate logistic regression analysis identified previous corticosteroid therapy (OR 6.68, 95% CI: 1.65-27.02) and male gender (OR 4.20, 95% CI: 1.16-15.21) as independent risk factors for recurrence following colchicine therapy.
  
  
  CONCLUSIONS
  Treatment with colchicine is highly effective in preventing recurrent pericarditis, while pretreatment with corticosteroids exacerbates and extends the course of recurrent pericarditis.
authors.affiliation: Cardiac Rehabilitation Institute, Sheba Medical Centre, Tel-Hashomer 52621, Israel.
authors.forename: Galit
authors.initials: G
authors.lastname: Artom
authors.forename: Nira
authors.initials: N
authors.lastname: Koren-Morag
authors.forename: David H
authors.initials: DH
authors.lastname: Spodick
authors.forename: Antonio
authors.initials: A
authors.lastname: Brucato
authors.forename: Joseph
authors.initials: J
authors.lastname: Guindo
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-de-Luna
authors.forename: Giovanni
authors.initials: G
authors.lastname: Brambilla
authors.forename: Yaron
authors.initials: Y
authors.lastname: Finkelstein
authors.forename: Brigitte
authors.initials: B
authors.lastname: Granel
authors.forename: Antoni
authors.initials: A
authors.lastname: Bayes-Genis
authors.forename: Ehud
authors.initials: E
authors.lastname: Schwammenthal
authors.forename: Yehuda
authors.initials: Y
authors.lastname: Adler
mesh_terms: D000293:Adolescent; D000305:Adrenal Cortex Hormones; D000328:Adult; D000368:Aged; D000369:Aged, 80 and over; D000893:Anti-Inflammatory Agents / Q000627:therapeutic use*; D002648:Child; D003078:Colchicine / Q000627:therapeutic use*; D000075202:Contraindications; D004347:Drug Interactions; D005260:Female; D006801:Humans; D008297:Male; D008875:Middle Aged; D010493:Pericarditis / Q000517:prevention & control*; D011788:Quality of Life; D012044:Regression Analysis; D012307:Risk Factors; D055502:Secondary Prevention; D015983:Selection Bias
chemical_list: D000305:Adrenal Cortex Hormones; D000893:Anti-Inflammatory Agents; D003078:Colchicine