Colchicine for Patients With Coronary Artery Disease: A Systematic Review and Meta-analysis

Shrestha, Dhan Bahadur; Budhathoki, Pravash; Sedhai, Yub Raj; Khadka, Manoj; Pokharel, Subashchandra; Yadav, Stuti; Patel, Toralben; Elgendy, Islam Y.; Mir, Wasey Ali Yadullahi; Patel, Nimesh

doi:10.1097/fjc.0000000000001200

Cited by 2 publications

(2 citation statements)

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“…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.…”

Section: The Strengths Of This Network Meta-analysismentioning

confidence: 99%

“…14,[16][17][18] Moreover, several meta-analyses have also confirmed the role of colchicine in patients with CAD. [19][20][21][22][23][24][25] However, multiple colchicine doses are used in practice, including low dose (0.5 mg once daily), high dose (1.0 mg once daily or 0.5 mg twice daily), and loading dose (initial dose plus a subsequent loading dose), and the optimal dose has been debated. 19,25,26 Therefore, this study used network meta-analysis to comprehensively evaluate the comparative efficacy and safety of 3 dosing regimens of colchicine in patients with CAD.…”

Section: Introductionmentioning

confidence: 99%

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

Wang

Yan-guang

Tan

et al. 2023

Journal of Cardiovascular Pharmacology

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Several meta-analyses have investigated the effects of different doses of colchicine in treating coronary artery disease, but all dosing regimens were never compared in a single study. We aimed to compare the efficacy and safety of 3 dosing regimens of colchicine in patients with coronary artery disease. PubMed, EMBASE, the Cochrane Library, and SCOPUS were searched for randomized controlled trials involving different colchicine doses. Major adverse cardiac events (MACE), all-cause and cardiovascular mortality, recurrent myocardial infarction (MI), stroke, gastrointestinal adverse events (AEs), discontinuation, and hospitalization were evaluated using risk ratio (RR) with 95% confidence interval (CI). A total of 15 randomized controlled trial involving 13,539 patients were included. Pooled results calculated with STATA 14.0 showed that low-dose colchicine significantly reduced MACE (RR, 0.51; 95% CI, 0.32–0.83), recurrent MI (RR, 0.56; 95% CI, 0.35–0.89), stroke (RR, 0.48; 95% CI, 0.23–1.00), and hospitalization (RR, 0.44; 95% CI, 0.22–0.85), whereas high and loading doses significantly increased gastrointestinal AEs (RR, 2.84; 95% CI, 1.26–6.24) and discontinuation (RR, 2.73; 95% CI, 1.07–6.93), respectively. Sensitivity analyses confirmed that 3 dosing regimens did not reduce all-cause and cardiovascular mortality but significantly increased the gastrointestinal AEs, and high dose significantly increased AEs-related discontinuation; loading dose resulted in more discontinuation than low dose. Although differences between 3 dosing regimens of colchicine are not significant, low dose is more effective in reducing MACE, recurrent MI, stroke, and hospitalization than the control, whereas high and loading doses increase gastrointestinal AEs and discontinuation, respectively.

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