We're unable to sign you in at this time. Please try again in a few minutes.
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
Editor's Correspondence |

Colchicine for Recurrent Acute Pericarditis

Antonio Brucato, MD; Giovanni Brambilla, MD; Yehuda Adler, MD; David H. Spodick, MD
Arch Intern Med. 2006;166(6):696. doi:10.1001/archinte.166.6.696.
Text Size: A A A
Published online


We congratulate Imazio et al1 for their excellent article on colchicine treatment for recurrent pericarditis. We also strongly agree that colchicine is useful for this condition,2 even in difficult patients.3 We have also used the half dose of 0.5 mg, in some conditions, to improve compliance.

On the other hand, in clinical practice many physicians do not believe colchicine works, perhaps because they still see recurrences after starting treatment with this drug. In our opinion, there are several explanations for this. First, colchicine is clearly useful for acute pericarditis but not for other types of pericardial diseases that are often erroneously labeled as “pericarditis”; for instance, it is not useful for painless chronic pericardial effusions with a normal C-reactive protein level. Second, some physicians discontinue treatment with corticosteroids and nonsteroidal anti-inflammatory drugs and add de novo colchicine, but treatment with only colchicine will probably lead to another failure. Finally, in complicated patients with a long history of recurrences at each corticosteroid withdrawal, adding colchicine treatment will give a good chance of controlling the disease only if the corticosteroid is tapered extremely slowly over months; in these difficult corticosteroid-dependent patients it is crucial to switch from rapid steroid-tapering to very gradual tapering to obtain a good control of the disease. Even if colchicine is not a magic bullet that alone will cure all the pericardial diseases and all the most complicated cases of recurrent acute pericarditis, the important article by Imazio et al1 should convince even the more skeptical cardiologists that colchicine really works when used correctly in the proper setting.

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

First Page Preview

View Large
First page PDF preview





Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.


Some tools below are only available to our subscribers or users with an online account.

11 Citations

Sign in

Purchase Options

• Buy this article
• Subscribe to the journal
• Rent this article ?

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles