Ancient rheumatism drug reduces recurring inflammation around heart

Reuters

WASHINGTON (Reuters) - A drug that was used in the time of the pharaohs for rheumatism has proven highly effective in treating recurrent bouts of pericarditis, an inflammation of the sac surrounding the heart, according to findings of a new clinical trial.

The ancient medicine, colchicine, which has also been used for centuries as an anti-inflammatory agent for acute gout, was tested against placebo in a 240-patient pericarditis trial.

The rate of recurring pericarditis was nearly halved for those taking colchicine compared with placebo, according to data presented on Sunday at the annual scientific sessions of the American College of Cardiology in Washington. The condition, which causes sharp chest pain, recurred in 42.5 percent of those taking dummy pills, compared with 21.6 percent of those who got colchicine.

Moreover, after three days of treatment, 19.2 percent of patients taking the drug had symptoms, compared with more than 44 percent of those given placebos. And those taking placebos, on average, had 0.63 recurrences, compared to 0.28 recurrences for those on colchicine.

With such fewer recurrences, the drug reduced the rate of hospitalizations to 1.7 percent, from 10 percent in the placebo group, potentially cutting healthcare costs at a time when pressure is mounting to limit costly hospital readmissions.

Although colchicine has been used for decades to treat pericarditis, following favorable trends seen in earlier trials, this was the first large formal multi-center study to examine use of the drug for multiple recurrences of the condition.

The favorable results will increase confidence in use of the medicine for pericarditis, researchers said.

Patients in the study received 0.5 milligrams of the drug either once or twice daily depending on their weight in addition to commonly used anti-inflammatory drugs such as aspirin or ibuprofen.

No serious side effects were associated with use of colchicine, researchers said, but gastrointestinal issues were reported in about eight percent of patients.

The reasons for pericarditis that repeatedly recurs once the original cause has been treated are not well understood, but potential causes are infections, kidney disease, cancer and heart surgery, researchers said.

"Health care providers should feel confident with the use of colchicine as a first line drug in patients with multiple recurrences of pericarditis," both for its safety and effectiveness, said Dr. Massimo Imazio, a cardiologist with Maria Vittoria Hospital in Torino, Italy, who led the trial.

Imazio said the study affirms that colchicine can be added to traditional treatments, such as anti-inflammatories and corticosteroids, and thereby provide an affordable treatment with few side effects.

(Reporting by Ransdell Pierson and Bill Berkrot; Editing by Diane Craft)

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