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. 2021 Jul 15;3(8):457-464.
doi: 10.1253/circrep.CR-21-0065. eCollection 2021 Aug 10.

Low-Dose Colchicine in Coronary Artery Disease - Systematic Review and Meta-Analysis

Ana Mafalda Abrantes  1 , Beatriz Nogueira-Garcia  2 , Mariana Alves  3   4   5 , Dúlio Teixeira Passos  1 , Dulce Brito  2   6   7 , Fausto J Pinto  2   6   7 , Daniel Caldeira  2   4   6   7
Affiliations

Low-Dose Colchicine in Coronary Artery Disease - Systematic Review and Meta-Analysis

Ana Mafalda Abrantes et al. Circ Rep. .

Abstract

Background: Recent studies have revealed the benefits of using colchicine, a drug with anti-inflammatory properties, in coronary artery disease (CAD). This study systematically reviewed the benefits and risks of low-dose colchicine in patients with CAD. Methods and Results: We searched for randomized controlled trials (RCTs) in MEDLINE, the Cochrane Central Register of Controlled Trials (CENTRAL), and Web of Science databases (March 2020). Efficacy and safety outcomes were evaluated. Estimates are expressed as risk ratios (RRs) and 95% confidence intervals (95% CIs). Heterogeneity was assessed with I2 test. Confidence in the pooled evidence was appraised using the GRADE framework. Colchicine reduced the rate of major adverse cardiovascular events (RR 0.65; 95% CI 0.49-0.86; 6 RCTs; I2=50%; 11,718 patients; GRADE, moderate confidence), acute coronary syndrome (RR 0.64; 95% CI 0.46-0.90; I2=47%; 7 RCTs; 11,955 patients; GRADE, very low confidence), stroke (RR 0.49; 95% CI 0.30-0.78; I2=0%; 6 RCTs; 11,896 patients; GRADE, moderate confidence), and cardiovascular interventions (RR 0.61; 95% CI 0.42-0.89; I2=40%; 4 RCTs; 11,284 patients; GRADE, high confidence). Colchicine did not increase the risk of adverse events, except for gastrointestinal events (RR 1.54; 95% CI 1.11-2.13; I2=72%; 9 RCTs; 12,374 patients; GRADE, very low confidence). Conclusions: Low-dose colchicine in patients with CAD is associated with beneficial effects on prognosis, although an increased risk of gastrointestinal events was confirmed.

Keywords: Atherosclerosis; Colchicine; Coronary artery disease; Inflammation.

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Conflict of interest statement

M.A. has participated in conferences with Boehringer-Ingelheim, AstraZeneca, Bayer, Bristol Myers Squibb Grünenthal, Tecnimede, and Merck Sharp & Dohme. D.B. reports personal fees from lectures or participation in advisory boards from Amgen, AstraZeneca, Boehringer-Ingelheim, Novartis, Pfizer, Roche Diagnostics, Servier and Vifor Pharma, all outside the submitted work. F.J.P. has received consultant and speaker fees from AstraZeneca, Bayer, BMS, Boehringer-Ingelheim, and Daiichi Sankyo. D.C. has participated in educational meetings and/or attended conferences or symposia (including travel, accommodation) with Daiichi Sankyo, Menarini, Merck Serono and Roche in the past 3 years.

Figures

Figure 1.
Figure 1.
Forest plot: cardiovascular mortality and major adverse cardiovascular events (MACE). CI, confidence interval.
Figure 2.
Figure 2.
Forest plot: acute coronary syndrome, stroke, heart failure, adverse events, and gastrointestinal adverse events. CI, confidence interval.
See this image and copyright information in PMC

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