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Colchicine for postoperative pericardial effusions: not the magic bullet for all kind of pericardial diseases!
  1. Massimo Imazio1,
  2. Fiorenzo Gaita2
  1. 1Cardiology Department, Maria Vittoria Hospital and Department of Public Health and Pediatrics, University of Torino, Torino, Italy
  2. 2University Division of Cardiology, Department of Medical Sciences, Città della Salute e della Scienza Hospital, University of Torino, Torino, Italy
  1. Correspondence to Professor Massimo Imazio, Cardiology Department, Maria Vittoria Hospital and Department of Public Health and Pediatrics, University of Torino, Via Luigi Cibrario 72, Torino 10141, Italy; massimo_imazio{at}yahoo.it, massimo.imazio{at}unito.it

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Colchicine is a very old drug that has been used for centuries for the treatment and prevention of gouty attacks. More recently, following its efficacy in the treatment and prevention of poliserositis attacks of familial Mediterranean fever (FMF), the drug has been proposed for the therapy of recurrent pericarditis in the absence of FMF. After the first non-randomised observations, a number of different multicentre, randomised, double-blind placebo-controlled clinical trials (RCT) have demonstrated its efficacy and safety in the treatment of acute and recurrent pericarditis (ICAP, CORP, CORP-2 trials)1–3 and also for the primary prevention of the postpericardiotomy syndrome (PPS) (COPPS, COPPS-2 trials).4 ,5

In the COPPS trial, colchicine, given postoperatively on day 3 after cardiac surgery, at the attack dose of 1.0 mg for 1 day followed by a maintenance dose of 0.5 mg twice daily for 1 month, prevented the PPS and postoperative effusions.4 ,6

On this basis, there is a growing interest in the use of this drug, which is relatively cheap and safe, being the most common side effect, …

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