Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases. (December 2015)

• Record Type: Journal Article
• Authors: Morel, N; Bonjour, M; Le Guern, V; Le Jeunne, C; Mouthon, L; Piette, J-C; Costedoat-Chalumeau, N
• Is Part Of: Lupus. Volume 24:Number 14(2015)
• Page Start: 1479
• Page End: 1485
• Publication Date: 2015-12
• Subjects: Systemic lupus erythematosus -- pericarditis -- colchicine; Systemic lupus erythematosus -- Periodicals; 616.772005
• DOI: 10.1177/0961203315593169
• Languages: English
• ISSNs: 0961-2033

Abstract

Objectives: Pericardial involvement is a frequent manifestation of systemic lupus erythematosus (SLE). Growing evidence suggests that colchicine may be useful for acute or recurrent pericarditis. We report for the first time a series of 10 consecutive cases of SLE with pericarditis treated with colchicine. Methods: Inclusion criteria in this retrospective study were diagnosis of SLE, pericarditis and receiving colchicine. Results: We included 10 consecutive cases of SLE with pericarditis treated with colchicine (nine women, mean age at the index pericarditis 35 ± 12 years). Pericarditis was the initial manifestation of SLE for two patients, whereas eight patients had SLE lasting for a median of 2.5 years (15 days to 13 years) and had received prednisone ( n = 7, 2–30 mg/d), hydroxychloroquine ( n = 7), azathioprine ( n = 3), methotrexate ( n = 2), and mycophenolate mofetil ( n = 1). For six patients, pericarditis was associated with other SLE manifestations. Altogether, colchicine avoided the use ( n = 2) or increase in dosage ( n = 5) of steroids in seven cases; the increase in steroids dosage was minimal for two patients. Colchicine 1 mg was given for a median of 39 days (10 days to 54 months). Symptoms completely resolved after a median of 2.5 days (1–30 days) after initiation of colchicine. Colchicine was maintained or resumed in six patients to prevent recurrence, with no further relapse. Conclusions: Colchicine may be safe and effective in treating SLE pericarditis and used as a steroids-sparing agent. These preliminary results need to be confirmed in a larger study with longer follow-up.