Colchicine for children with pericarditis: systematic review of clinical studies

OBJECTIVE: To review the evidence for the efficacy and safety of colchicine in children with pericarditis. DESIGN: Systematic review. SEARCH STRATEGY: The following databases were searched for studies about colchicine in children with pericarditis (June 2015): Cochrane Central, Medline, EMBASE and LILACS. ELIGIBILITY CRITERIA: All observational and experimental studies on humans with any length of follow-up and no limitations on language or publication status were included. The outcomes studied were recurrences of pericarditis and adverse events. DATA EXTRACTION: Two authors extracted data and assessed quality of included studies using the Cochrane risk of bias tool for non-randomised trials. RESULTS: Two case series and nine case reports reported the use of colchicine in a total of 86 children with pericarditis. Five articles including 74 paediatric patients were in favour of colchicine in preventing further pericarditis recurrences. Six studies including 12 patients showed that colchicine did not prevent recurrences of pericarditis. LIMITATIONS: No randomised controlled trials (RCTs) were found. CONCLUSIONS: Although colchicine is an established treatment for pericarditis in adults, it is not routinely used in children. There is not enough evidence to support or discourage the use of colchicine in children with pericarditis. Further research in the form of large double-blind RCTs is needed to establish the efficacy of colchicine in children with pericarditis.