Colchicine for secondary prevention of cardiovascular disease

Curr Atheroscler Rep. 2014 Mar;16(3):391. doi: 10.1007/s11883-013-0391-z.

Abstract

Preliminary evidence demonstrating that adding 0.5 mg of colchicine per day to statin and antiplatelet therapy reduced the risk of acute coronary events in patients with stable coronary artery disease has raised the hope that it may prove effective for the long-term secondary prevention of cardiovascular disease. The ability of colchicine to suppress blood levels of inflammatory mediators and prevent cholesterol-crystal-induced neutrophil-mediated inflammation implicated in the progression and instability of atherosclerosis adds plausibility to this clinical observation. Early intestinal intolerance in some patients is well recognized, but clinical experience gained over more than half a century with the continuous use of colchicine for the prevention of neutrophil-mediated inflammation in patients with familial Mediterranean fever and gout indicates that low-dose long-term therapy is safe. Nonetheless, before colchicine can be recommended for the secondary prevention of cardiovascular disease, further studies are required to confirm its safety and efficacy in a broad range of patients with coronary disease, and to determine whether doses of colchicine less than 0.5 mg/day might be effective and even better tolerated. Trials exploring the role of colchicine in the treatment of patients with acute coronary syndromes would also be of special interest but may require the use of doses higher than those used for long-term secondary prevention.

Publication types

  • Review

MeSH terms

  • Acute Coronary Syndrome* / etiology
  • Acute Coronary Syndrome* / prevention & control
  • Clinical Trials as Topic
  • Colchicine* / administration & dosage
  • Colchicine* / adverse effects
  • Coronary Artery Disease* / complications
  • Coronary Artery Disease* / drug therapy
  • Coronary Artery Disease* / immunology
  • Coronary Artery Disease* / physiopathology
  • Dose-Response Relationship, Drug
  • Gastrointestinal Diseases / chemically induced
  • Gout Suppressants / administration & dosage
  • Gout Suppressants / adverse effects
  • Humans
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors / therapeutic use
  • Inflammation / immunology
  • Inflammation / prevention & control
  • Secondary Prevention / methods
  • Time
  • Treatment Outcome

Substances

  • Gout Suppressants
  • Hydroxymethylglutaryl-CoA Reductase Inhibitors
  • Colchicine