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Colchicine prevents early postoperative pericardial and pleural effusions
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Colchicine prevents early postoperative pericardial and pleural effusions
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Journal Article
Colchicine prevents early postoperative pericardial and pleural effusions
2011
Overview
No preventive pharmacologic strategies have been proven efficacious for the prevention of postoperative effusions after cardiac surgery. Colchicine is safe and efficacious for the prevention of pericarditis. On this basis, we realized a substudy of the COPPS trial to assess the efficacy and safety of colchicine for the prevention of postoperative pericardial and pleural effusions.
The COPPS is a multicenter, double-blind, randomized trial, where 360 consecutive patients (mean age 65.7 ± 12.3 years, 66% men), 180 in each treatment arm, were randomized on the third postoperative day to receive placebo or colchicine for 1 month (1.0 mg twice daily for the first day, followed by a maintenance dose of 0.5 mg twice daily in patients ≥70 kg, and halved doses for patients <70 kg). The incidence of postoperative effusions was evaluated in each study group.
Despite similar baseline features, colchicine significantly reduced the incidence of postoperative pericardial (12.8% vs 22.8%,
P = .019, relative risk reduction 43.9%, no. of patients needed to treat 10) and pleural effusions (12.2% vs 25.6%,
P = .002, relative risk reduction 52.3%, no. of patients needed to treat 8). The rate of side effects (only gastrointestinal intolerance) and drug withdrawal was similar in the study groups with a trend toward an increased rate of both events for colchicine. In multivariable analysis, female gender (hazard ratio 1.76, 95% CI 1.03-3.03,
P = .040) and pleura incision (hazard ratio 2.58, 95% CI 1.53-4.53,
P < .001) were risk factors for postoperative effusions.
Colchicine is safe and efficacious for the primary prevention of postoperative effusions after cardiac surgery.
Publisher
Mosby, Inc,Mosby,Elsevier Limited
Subject
/ Biological and medical sciences
/ Cardiac Surgical Procedures - adverse effects
/ Chronic obstructive pulmonary disease
/ Colchicine - administration & dosage
/ Colchicine - therapeutic use
/ Dose-Response Relationship, Drug
/ Female
/ Heart
/ Humans
/ Kinases
/ Male
/ Nonsteroidal anti-inflammatory drugs
/ Pericardial Effusion - epidemiology
/ Pericardial Effusion - etiology
/ Pericardial Effusion - prevention & control
/ Pleural Effusion - epidemiology
/ Pleural Effusion - prevention & control
/ Respiratory system : syndromes and miscellaneous diseases
/ Software
/ Tubulin Modulators - administration & dosage
