Letter Regarding Article by Imazio et al, “Colchicine in Addition to Conventional Therapy for Acute Pericarditis”

To the Editor:We congratulate Imazio et al1 for their excellent article on colchicine in acute pericarditis. We see 2 take-home messages in this study: first, that colchicine is useful in the first attack, and second, that corticosteroid therapy given in the first attack favors the recurrence of pericarditis. This concept is in line with our recent findings that pretreatment with steroids attenuates the efficacy of colchicine in preventing recurrent pericarditis2 and with animal experiments showing that corticosteroids may exacerbate virally induced pericardial injury. Thus, the results reported by Imazio et al1 and those from our multicenter study should strongly encourage clinicians not to use corticosteroids except in extreme, very rare cases. Although their use may be very gratifying in the short term, it will greatly complicate the following course. On the other hand, a …