weight-adjusted maintenance dose without any
loading dose.
A number of limitations of our study should be
considered. Our findings might not be generalizable
to other clinical conditions or other patient
populations; in this regard, we excluded patients
with elevated levels of aminotransferases, creatinine,
or troponin and those with liver disease,
myopathy, blood dyscrasias, or inflammatory
bowel disease. Our results should not be applied
to women who are pregnant or lactating or to
children. We also excluded patients with bacterial
or neoplastic pericarditis. Of note, colchicine is
not approved for the prevention of recurrent pericarditis
in North America or Europe, and its use
as such is off-label. Our limited sample size might
have precluded the identification of rare adverse
effects. Further research is needed to identify the
best duration of colchicine treatment, since we
selected the arbitrary treatment length of 3 months
on the basis of previous studies,3-5 and we speculate
that a longer duration might further decrease
the 9 to 10% recurrence rate.
In conclusion, we conducted a randomized trial
of colchicine versus placebo, in addition to conventional
antiinflammatory therapy, in patients
with a first episode of acute pericarditis. Colchicine
reduced the rate of incessant or recurrent
pericarditis in these patients, as compared with
placebo.