Comparative Efficacy and Safety of Colchicine and Anti-Interleukin-1 Agents in Recurrent Pericarditis: A Pairwise and Network Meta-Analysis of Randomized Controlled Trials.

IF 5 1区医学 Q1 CARDIAC & CARDIOVASCULAR SYSTEMS

Journal of the American Heart Association Pub Date : 2025-06-23 DOI:10.1161/JAHA.125.041007

Muhammad Ehsan, Alveena Batool Syed, Biah Mustafa, Jibran Ikram, Muhammad Hammad Khan, Paul C Cremer, Massimo Imazio, Tom Kai Ming Wang, Allan L Klein

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引用次数: 0

Abstract

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.

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秋水仙碱和抗白细胞介素-1药物治疗复发性心包炎的疗效和安全性比较：随机对照试验的成对和网络meta分析。

背景：考虑到非甾体抗炎药和皮质类固醇的有限疗效和不良反应，复发性心包炎的治疗包括秋水仙碱和抗白细胞介素-1药物。我们对秋水仙碱和抗白细胞介素-1药物治疗复发性心包炎的疗效和安全性进行了两两和网络荟萃分析。方法：综合检索各种数据库，检索相关的随机对照试验。在R中使用精确的Mantel-Haenszel方法进行两两荟萃分析。我们还以秋水仙碱组作为比较物进行了网络荟萃分析。结果：meta分析共纳入6项随机对照试验。与安慰剂或标准治疗相比，秋水仙碱（风险比[RR]， 0.46 [95% CI, 0.37-0.58]）和抗白细胞介素-1药物（RR, 0.12 [95% CI, 0.03-0.54]）显著降低心包炎复发的风险。秋水仙碱显著降低治疗失败的风险（RR, 0.42 [95% CI, 0.31-0.57]）和心包炎相关再住院的风险（RR, 0.26 [95% CI, 0.10-0.70]），但对不良事件的风险没有显著影响（RR, 1.06 [95% CI, 0.31-3.62]）。抗白细胞介素-1药物与不良事件风险显著增加相关（RR, 1.88 [95% CI, 1.60-2.21]）。网络荟萃分析显示，抗白细胞介素-1药物比秋水仙碱更能降低心包炎复发（RR, 0.27 [95% CI, 0.11-0.67]），但在不良事件方面无显著差异（RR, 1.77 [95% CI, 0.88-3.57]）。结论：秋水仙碱和抗白细胞介素-1均能有效降低心包炎复发的风险。抗白细胞介素-1药物与更频繁的非严重不良事件相关，但关于严重不良事件的证据仍不确定。

本文章由计算机程序翻译，如有差异，请以英文原文为准。

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来源期刊

Journal of the American Heart Association CARDIAC & CARDIOVASCULAR SYSTEMS-

CiteScore

9.40

自引率

1.90%

发文量

1749

审稿时长

12 weeks

期刊介绍： As an Open Access journal, JAHA - Journal of the American Heart Association is rapidly and freely available, accelerating the translation of strong science into effective practice. JAHA is an authoritative, peer-reviewed Open Access journal focusing on cardiovascular and cerebrovascular disease. JAHA provides a global forum for basic and clinical research and timely reviews on cardiovascular disease and stroke. As an Open Access journal, its content is free on publication to read, download, and share, accelerating the translation of strong science into effective practice.