A decades-old medication used to treat gout has taken on a new life in preventing multiple episodes (greater than 2) of recurrent pericarditis. But with its new name comes a hefty price increase.
Cleveland Clinic is a non-profit academic medical center. Advertising on our site helps support our mission. We do not endorse non-Cleveland Clinic products or services. Policy
Attendees at the American College of Cardiology’s 63rd Annual Scientific Session and Expo heard a report on the CORP-2 trials. The trials looked at how well and how safely colchicine helps prevent recurrent bouts of pericarditis. This study builds on the previous CORP trial to help prevent recurrent pericarditis.
Recurrent pericarditis is a well-known complication of acute pericarditis (inflammation of the sac that lines the heart). It troubles over 30 percent of pericarditis patients.
Even though research results on treating with colchicine look promising, patients will face sticker shock at the pharmacy. The patent medication is very expensive. However, there are programs that may offer to help patients pay for the drug.
Natural cure now under patent protection
Originally used to treat gout, colchicine derives from a centuries-old, plant-based cure that used autumn crocus, or Colchicum autumnale, in its preparation.
Currently, the patent version of the drug, Colcrys, has FDA approval as a treatment for gout. The trials aim to gain its official approval as first-line treatment for acute and recurrent pericarditis.
The problem is that the formerly inexpensive generic colchicine is no longer available. The cost of the patented version for the drug ballooned from nine cents to five dollars per pill – a price hike that might make even healthy patients swoon.
Research trials presented at ACC conference
The Colchicine for Recurrent Pericarditis 2 Study (also known as ASLT02 and conducted under the support of the Italian National Health Service) looked at data from a total of 240 patients over a period of six months.
The patients had recurrent pericarditis, 82 percent of which was of idiopathic (unknown) origin. Half the patients received colchicine (0.5 mg by mouth twice a day) treatment in addition to traditional treatment including standard NSAID’s. The other half did not.
After six months, patients treated with colchicine had a disease recurrence rate of just over 20 percent. The group that did not receive colchicine had a 42 percent recurrence rate. The medication also helped similarly reduce short-term persistence of symptoms (measured at 72 hours).
Allan L. Klein, MD, Director of Cleveland Clinic’s Center for the Diagnosis and Treatment of Pericardial Diseases, did not participate in the study. After reviewing the results, he says it does “perhaps confirm its utility as first-line therapy for multiple episodes of recurrent pericarditis in the absence of contraindications (reasons to withhold a certain medical treatment).” However, he tempers the optimistic findings with caution. He notes that colchicine is not without side effects. It can cause diarrhea and the dose will need adjusted in patients who have reduced kidney function. Of note in the U.S., the drug is off-label with a dose of 0.6mg by mouth twice a day and is currently used in patients with acute and recurrent pericarditis.