Efficacy of Colchicine for Secondary Prevention of Stroke: A Systematic Review and Meta-Analysis of Randomized Control Trials

Colchicine, a long-established anti-inflammatory medication, has emerged as a potential therapeutic agent for secondary prevention of stroke. This systematic review and meta-analysis aimed to evaluate the efficacy and safety of colchicine in preventing secondary stroke by comprehensively synthesizing available evidence. A systematic literature search was conducted across multiple electronic databases from inception to November 15, 2024, using comprehensive search strategies. Randomized controlled trials involving colchicine administration for stroke prevention were included. Two independent reviewers screened studies, extracted data, and assessed methodological quality using the Cochrane Risk of Bias tool. Meta-analysis was performed using Review Manager software, with risk ratios calculated for stroke incidence and all-cause mortality. The analysis encompassed seven studies involving 23,303 participants. The meta-analysis revealed a borderline significant 24% relative risk reduction in stroke incidence (risk ratio 0.76, 95% confidence interval 0.57-1.00, p = 0.05). Moderate heterogeneity was observed among studies (I² = 50%). Importantly, no significant difference was found in all-cause mortality between colchicine and control groups (risk ratio 1.03, 95% confidence interval 0.91-1.17, p = 0.66). While the findings suggest potential benefits of colchicine in stroke prevention, the results warrant cautious interpretation. The study emphasizes the need for larger, well-designed randomized controlled trials to definitively establish colchicine's role in comprehensive stroke prevention strategies.