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Colchicine may prevent CV events in patients with stable coronary disease
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Colchicine, often used for treating gout and familial Mediterranean fever because of its anti-inflammatory properties that inhibit neutrophil function, appeared to reduce the risk for CV events in patients with stable coronary disease, according to study results.
The Low-Dose Colchicine trial (LoDoCo) involved 523 patients with stable coronary disease receiving aspirin and/or clopidogrel (93%) and statins (95%) who were randomly assigned colchicine 0.5 mg/day or no colchicine. Patients were observed for a median of 3 years.
The primary endpoint — composite of ACS, out-of-hospital cardiac arrest or noncardioembolic ischemic stroke — was reached in 5.3% of patients assigned colchicine and 16% assigned no colchicine (HR=0.33; 95% CI, 0.18-0.59).
The researchers also conducted a prespecified secondary on-treatment analysis that excluded 39 withdrew from the study within 30 days due to adverse effects or did not start treatment. In this group, the primary outcome occurred in 4.5% of patients assigned colchicine and 16% assigned no colchicine (HR=0.29; 95% CI, 0.15-0.56).
According to the researchers, widespread use of colchicine may be limited by its adverse effects, such as intestinal intolerance, risk for myalgia and acute rhabdomyolysis in patients with renal failure.
“The major implications of these findings are that it may be possible to reduce the risk of CV events in patients with stable coronary disease by targeting an inflammatory pathway that has been identified in native unstable atherosclerotic plaques using a low dose of colchicine,” Stefan M. Nidorf, MD, MBBS, of Heart Care Western Australia, and colleagues wrote in the Journal of the American College of Cardiology.
Disclosure: See the full study for a list of the researchers’ relevant financial disclosures.
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