Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials
Background The management of recurrent pericarditis includes colchicine and anti–interleukin‐1 agents, given the limited efficacy and adverse effects of NSAIDs and corticosteroids. We conducted a pairwise and network meta‐analysis to evaluate the efficacy and safety of colchicine and anti–interleuki...
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| Format: | Article |
| Language: | English |
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Wiley
2025-07-01
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| Series: | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
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| Online Access: | https://www.ahajournals.org/doi/10.1161/JAHA.125.041007 |
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| author | Muhammad Ehsan Alveena Batool Syed Biah Mustafa Jibran Ikram Muhammad Hammad Khan Paul C. Cremer Massimo Imazio Tom Kai Ming Wang Allan L. Klein |
| author_facet | Muhammad Ehsan Alveena Batool Syed Biah Mustafa Jibran Ikram Muhammad Hammad Khan Paul C. Cremer Massimo Imazio Tom Kai Ming Wang Allan L. Klein |
| author_sort | Muhammad Ehsan |
| collection | DOAJ |
| description | Background The management of recurrent pericarditis includes colchicine and anti–interleukin‐1 agents, given the limited efficacy and adverse effects of NSAIDs and corticosteroids. We conducted a pairwise and network meta‐analysis to evaluate the efficacy and safety of colchicine and anti–interleukin‐1 agents in recurrent pericarditis. Methods We conducted a comprehensive search on various databases to retrieve relevant randomized controlled trials. Pairwise meta‐analyses were performed in R using the exact Mantel–Haenszel method. We also performed a network meta‐analysis with a colchicine group as the comparator. Results A total of 6 randomized controlled trials were included in the meta‐analysis. The risk of pericarditis recurrence was significantly decreased by colchicine (risk ratio [RR], 0.46 [95% CI, 0.37–0.58]) and anti–interleukin‐1 agents (RR, 0.12 [95% CI, 0.03–0.54]) compared with placebo or standard therapy. Colchicine significantly decreased the risk of treatment failure (RR, 0.42 [95% CI, 0.31–0.57]) and pericarditis‐related rehospitalization (RR, 0.26 [95% CI, 0.10–0.70]) but did not have a significant impact on the risk of adverse events (RR, 1.06 [95% CI, 0.31–3.62]). Anti–interleukin‐1 agents were associated with a significantly increased risk of adverse events (RR, 1.88 [95% CI, 1.60–2.21]). The network meta‐analysis showed that anti–interleukin‐1 agents were associated with a greater reduction in pericarditis recurrence than colchicine (RR, 0.27 [95% CI, 0.11–0.67]), with no significant difference with respect to adverse events (RR, 1.77 [95% CI, 0.88–3.57]). Conclusions Both colchicine and anti–interleukin‐1 agents are effective in reducing the risk of recurrent pericarditis. Anti–interleukin‐1 agents are associated with more frequent nonserious adverse events, but evidence on serious adverse events remains inconclusive. |
| format | Article |
| id | doaj-art-c3a5c810a2de444c81c657278bcd4dd2 |
| institution | DOAJ |
| issn | 2047-9980 |
| language | English |
| publishDate | 2025-07-01 |
| publisher | Wiley |
| record_format | Article |
| series | Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease |
| spelling | doaj-art-c3a5c810a2de444c81c657278bcd4dd22025-08-20T02:46:24ZengWileyJournal of the American Heart Association: Cardiovascular and Cerebrovascular Disease2047-99802025-07-01141310.1161/JAHA.125.041007Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled TrialsMuhammad Ehsan0Alveena Batool Syed1Biah Mustafa2Jibran Ikram3Muhammad Hammad Khan4Paul C. Cremer5Massimo Imazio6Tom Kai Ming Wang7Allan L. Klein8Center for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute Cleveland OH USAResident Physician, Department of Internal Medicine Cleveland Clinic Foundation Cleveland OH USADepartment of Medicine King Edward Medical University Lahore PakistanCenter for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute Cleveland OH USADepartment of Medicine King Edward Medical University Lahore PakistanDivision of Cardiology, Bluhm Cardiovascular Institute Northwestern Medicine, Northwestern University Feinberg School of Medicine Chicago IL USADepartment of Medicine University of Udine ItalyCenter for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute Cleveland OH USACenter for the Diagnosis and Treatment of Pericardial Diseases, Section of Cardiovascular Imaging, Department of Cardiovascular Medicine Heart, Vascular and Thoracic Institute Cleveland OH USABackground The management of recurrent pericarditis includes colchicine and anti–interleukin‐1 agents, given the limited efficacy and adverse effects of NSAIDs and corticosteroids. We conducted a pairwise and network meta‐analysis to evaluate the efficacy and safety of colchicine and anti–interleukin‐1 agents in recurrent pericarditis. Methods We conducted a comprehensive search on various databases to retrieve relevant randomized controlled trials. Pairwise meta‐analyses were performed in R using the exact Mantel–Haenszel method. We also performed a network meta‐analysis with a colchicine group as the comparator. Results A total of 6 randomized controlled trials were included in the meta‐analysis. The risk of pericarditis recurrence was significantly decreased by colchicine (risk ratio [RR], 0.46 [95% CI, 0.37–0.58]) and anti–interleukin‐1 agents (RR, 0.12 [95% CI, 0.03–0.54]) compared with placebo or standard therapy. Colchicine significantly decreased the risk of treatment failure (RR, 0.42 [95% CI, 0.31–0.57]) and pericarditis‐related rehospitalization (RR, 0.26 [95% CI, 0.10–0.70]) but did not have a significant impact on the risk of adverse events (RR, 1.06 [95% CI, 0.31–3.62]). Anti–interleukin‐1 agents were associated with a significantly increased risk of adverse events (RR, 1.88 [95% CI, 1.60–2.21]). The network meta‐analysis showed that anti–interleukin‐1 agents were associated with a greater reduction in pericarditis recurrence than colchicine (RR, 0.27 [95% CI, 0.11–0.67]), with no significant difference with respect to adverse events (RR, 1.77 [95% CI, 0.88–3.57]). Conclusions Both colchicine and anti–interleukin‐1 agents are effective in reducing the risk of recurrent pericarditis. Anti–interleukin‐1 agents are associated with more frequent nonserious adverse events, but evidence on serious adverse events remains inconclusive.https://www.ahajournals.org/doi/10.1161/JAHA.125.041007colchicinenetwork meta‐analysisRCTsrecurrencerecurrent pericarditis |
| spellingShingle | Muhammad Ehsan Alveena Batool Syed Biah Mustafa Jibran Ikram Muhammad Hammad Khan Paul C. Cremer Massimo Imazio Tom Kai Ming Wang Allan L. Klein Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials Journal of the American Heart Association: Cardiovascular and Cerebrovascular Disease colchicine network meta‐analysis RCTs recurrence recurrent pericarditis |
| title | Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials |
| title_full | Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials |
| title_fullStr | Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials |
| title_full_unstemmed | Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials |
| title_short | Comparative Efficacy and Safety of Colchicine and Anti–Interleukin‐1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta‐Analysis of Randomized Controlled Trials |
| title_sort | comparative efficacy and safety of colchicine and anti interleukin 1 agents in recurrent pericarditis a pairwise and network meta analysis of randomized controlled trials |
| topic | colchicine network meta‐analysis RCTs recurrence recurrent pericarditis |
| url | https://www.ahajournals.org/doi/10.1161/JAHA.125.041007 |
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