Colchicine helps prevent future cardiovascular events in CAD

Among patients with coronary artery disease (CAD), colchicine use may suppress risk of future cardiovascular events, reports a new meta-analysis.

From the databases of PubMed, the Cochrane Library, and Scopus, the researchers identified five randomized controlled trials eligible for meta-analysis. These studies contributed a cumulative sample of 11,790 CAD patients, all followed for ≥6 months. The primary efficacy outcome was the development of major adverse cardiovascular events (MACE).

Of the patients, 5,906 had been given colchicine, while 5,884 had received a control agent. Those in the former saw a 35-percent drop in the risk of developing MACE (relative risk [RR], 0.65, 95 percent confidence interval [CI], 0.52–0.82; p<0.001). Heterogeneity among studies was moderate (p=0.09), and removing each trial one at a time did not attenuate the risk estimate.

Looking at each individual component, the researchers found that the overall protective effect of colchicine on MACE was driven by lowered risks in terms of myocardial infarction (RR, 0.73, 95 percent CI, 0.55–0.98; p=0.04), coronary revascularization (RR, 0.61, 95 percent CI, 0.45–0.89; p=0.01), and stroke (RR, 0.47, 95 percent CI, 0.28–0.81; p=0.007).

Cardiovascular death, on the other hand, was not significantly affected by colchicine use (RR, 0.79, 95 percent CI, 0.43–1.45; p=0.45).

In terms of safety, a slight increase in the likelihood of noncardiovascular death was observed, though without achieving significance (RR, 1.50, 95 percent CI, 0.93–2.40; p=0.09). Gastrointestinal disturbances, infections, pneumonia, cancer, and myalgia likewise occurred at comparable frequencies between colchicine and placebo arms.