Colchicine: a simple and effective treatment for pericarditis in systemic lupus erythematosus? A report of 10 cases

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 3512 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, 2-30mg/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 1mg 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.