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The paucity of patients denies most physicians, including many cardiologists, close (or often any) working acquaintance with pericardial disease, while the experiences of those of us in some referral institutions and practices permit us to style ourselves as pericardiologists.1 Massimo Imazio, the leading clinician-investigator of acute pericardial disease, solved the quantitative patient problem by bringing together a group of Northern Italian hospitals;2 he, and his colleagues from Italy, the USA and Israel, collated data pertaining to a large number of patients, as outlined in the report on the efficacy and safety of colchicine therapy.3 While empirical anti-inflammatory treatment is the mainstay,4 colchicine is the only specific drug that has proven to be efficacious, particularly to prevent and treat the most challenging conditions: recurrent and incessant pericarditis.5 Moreover, the present report is a careful meta-analysis covering primary outcome, adverse events and drug withdrawal in five controlled clinical trials, four of them by Imazio and colleagues. Three trials were double-blind randomised controlled trials (RCTs) and two were …
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