Colchicine Versus Placebo in Acute Myocarditis Patients
Status:
Not yet recruiting
Trial end date:
2027-06-01
Target enrollment:
Participant gender:
Summary
Myocarditis is an inflammatory disease of the heart, mostly caused by viruses. Patients with
acute myocarditis are exposed to several complications: recurrence, ventricular arrhythmias
(from 5 to 30%), heart failure (5-10%), death or heart transplantation (< 4%). To date, there
is no specific treatment for myocarditis. Patient management only focuses upon empirical
optimal care of arrhythmia and heart failure.
There is a strong rationale for using colchicine in acute myocarditis:
- the IL1 (Interleukin1) pathway plays a detrimental role in acute myocarditis. NLRP3
(NOD-like receptor family, pyrin domain containing 3) inflammasome assembly, and
subsequent IL-1beta production, are profoundly inhibited by colchicine.
- colchicine has been shown to improve cardiac outcomes in inflammatory cardiac disorders,
including pericarditis, coronary artery disease, and post pericardiotomy syndrome.
- In murine model of CVB3-induced myocarditis (coxsackievirus B3), colchicine improved
myocarditis through reduction of NLRP3 activity.
- Small case series with improvement of left ejection fraction in myocarditis following
low-dose colchicine in addition to conventional heart failure therapy have been
reported.
With its pleiotropic anti-inflammatory effect in the pro-inflammatory cascade, reducing the
myocardial damage and cell death induced during myocarditis, colchicine has the potential to
reduce the risk of heart failure and ventricular arrhythmias. Finally, colchicine is a drug
widely available, at low cost, and has a long and well-known safety record.