A Meta-Analysis Evaluating the Colchicine Therapy in Patients With Coronary Artery Disease

Abstract

Background: Evidence from recent studies has shown the benefits of colchicine for patients with coronary artery disease. The aim was to assess the effect of colchicine treatment on cardiovascular events, with an estimation of the risk of discontinuation and net clinical benefit.Methods and Results: Fourteen trials with a total of 13,186 patients were selected through a systematic search. Colchicine therapy significantly reduced the relative risk of primary endpoint by about 30% [RR 0.70 (95%CI:0.56–0.88)]. Compared with placebo, colchicine significantly reduced the risk of ischemia-driven revascularization [RR 0.57 (95%CI 0.41–0.80)], ischemia-driven revascularization and resuscitation [RR 0.50 (95%CI 0.34–0.73)], myocardial infarction [RR 0.73 (95%CI 0.57–0.95)], and stroke [RR 0.49 (95%CI 0.30–0.7)]. Patients treated with colchicine in comparison with placebo have a significant increase in the risk of treatment cessation (RR 1.60 95%CI 1.06–2.42). However, in the analysis which excluded studies without placebo, the relative risk of discontinuation was smaller (RR 1.34 95%CI 0.97–1.84) and in the three largest studies, the risk of discontinuation was lower and insignificant [RR 1.26 (95%CI 0.87–1.83)]. The net clinical benefit was 17.8/1,000 patients (p < 0.001).Conclusion: In coronary artery disease, low-dose colchicine significantly reduces the risk of the primary composite endpoint by about 30%. The drug should be considered as part of the preventive treatment in patients with good tolerance.

Efficacy and safety of drugs in residual cardiovascular risk: A systematic review of the literature

“…Consistently with these results, the 13 clinical trials by Kofler (2021) [ 32 ] and 14 clinical trials by Grajek (2021) [ 33 ] meta–analyses evaluating the efficacy of colchicine in patients with coronary artery disease found a reduction in MACE of 35 % and 30 %, respectively, relative to placebo, positioning this drug product as one of the therapies of choice in this setting alongside usual medical therapy.…”

Stress hyperglycemia ratio and neutrophil to lymphocyte ratio are reliable predictors of new-onset atrial fibrillation in patients with acute myocardial infarction

“…Colchicine is an anti-inflammatory drug widely used to treat gout. Recent literature suggested that low-dose colchicine had cardiovascular benefits in patients with acute coronary syndrome through reducing inflammation ( 33 ). The effect of anti-inflammatory therapy on NOAF after AMI should also be studied in the future.…”

Efficacy and safety of different dosing regimens of colchicine in patients with coronary artery disease: a network meta-analysis of 15 randomized controlled trials

“…To date, many conventional pairwise meta-analyses have systematically evaluated and consistently established the effects and safety of colchicine for the treatment of patients with CAD [19][20][21][22][23][24][25][26]63,68,69 ; however, all these findings from previous meta-analyses did not inform practitioners which dosing regimen may be preferred for these patients. Given this open issue, the current network meta-analysis rationally classified colchicine dose into 3 regimens based on published evidence 26 and first determined the comparative efficacy and safety among 3 dosing regimens.…”