Effect of colchicine on inflammatory markers in patients with coronary artery disease: A meta-analysis of clinical trials

Meta-Analysis of Randomized Trials: Efficacy and Safety of Colchicine for Secondary Prevention of Cardiovascular Disease

“…There was also a reduction of the upstream NF- κ B essential modulator, required in NLRP3 activation [ 28 ]. In a large meta-analysis investigating the effects of colchicine on inflammatory markers in patients with CAD across 11 clinical trials, colchicine led to a significant reduction in hs-CRP (weighted mean differences (WMDs), −0.81 mg/L; 95% confidence interval (CI), −1.34 to 0.28 mg/L; P =0.003) and IL-6 levels (WMD, −1.28 pg/mL; 95% CI, −2.35 to −0.21 pg/mL; P =0.02) compared with placebo [ 29 ]. From a clinical standpoint, colchicine is inexpensive and taken orally.…”

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 19–26,63,68,69 ; 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. Generally speaking, our network meta-analysis yielded these novel findings due to the following methodological advantages: (1) this network meta-analysis combined both direct and indirect evidence to evaluate the differences between the 3 dosing regimens of colchicine; (2) the current network meta-analysis meaningfully classified dose of colchicine into low, high, and loading dose rather than simply high and low dose, which was beneficial in providing more detail for clinical decision making; (3) our network meta-analysis performed sensitivity analyses based on the results of the transitivity assessment, which was beneficial to examine the robustness and reliability of our findings; (4) a network meta-regression was performed to confirm that possible effect modifiers (disease type and follow-up duration) did not have effect on the robustness of pooled results; (5) more clinical and safety outcomes were evaluated in our network meta-analysis, providing a more comprehensive profile for effect and safety of colchicine; and (6) SUCRA values were calculated to rank the 3 dosing regimens of colchicine, which can help in developing the correct treatment strategy.…”

“…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.…”

“…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. Generally speaking, our network meta-analysis yielded these novel findings due to the following methodological advantages: (1) this network meta-analysis combined both direct and indirect evidence to evaluate the differences between the 3 dosing regimens of colchicine; (2) the current network meta-analysis meaningfully classified dose of colchicine into low, high, and loading dose rather than simply high and low dose, which was beneficial in providing more detail for clinical decision making;…”

“…[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.…”