A widely-used, inexpensive gout medication has demonstrated significant potential in preventing heart attacks and strokes in people with cardiovascular disease, according to a comprehensive new Cochrane review. The analysis examined low-dose colchicine, revealing promising cardiovascular benefits without serious safety concerns.
Anti-Inflammatory Approach to Cardiovascular Protection
Cardiovascular disease is often driven by chronic low-grade inflammation, which contributes to recurrent cardiovascular events such as heart attacks and strokes. Colchicine's anti-inflammatory properties make it a promising therapeutic option for people with heart disease, offering a novel approach to secondary prevention.
The review included 12 randomized controlled trials involving nearly 23,000 people with a history of heart disease, heart attack or stroke. Participants took colchicine for at least six months, with doses of 0.5 mg once or twice daily. The study population was predominantly male (~80%) with a mean age ranging from 57 to 74 years old. Half received colchicine, while the other half received either a placebo or no additional treatment alongside their usual care.
Significant Risk Reduction Demonstrated
The results showed that those taking low-dose colchicine were less likely to experience a heart attack or stroke. For every 1,000 people treated, there were 9 fewer heart attacks and 8 fewer strokes compared with those not taking the drug. No serious adverse events were identified, though patients who took colchicine were more likely to experience stomach or digestive side effects, which were typically mild and short-lived.
"Among 200 people with cardiovascular disease – where we would normally expect around seven heart attacks and four strokes – using low-dose colchicine could prevent about two of each," explains Dr. Ramin Ebrahimi, co-lead author from University Medicine Greifswald, Germany. "Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk."
Repurposing Strategy Shows Academic Research Value
Since cardiovascular diseases remain the leading cause of death worldwide, colchicine offers a potentially affordable and widely available strategy for preventing additional heart problems in high-risk patients. The findings highlight the value of repurposing established medications for new therapeutic applications.
"These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use," notes Lars Hemkens, senior author from the University of Bern, Switzerland. "It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks."
Research Gaps Remain
Questions still remain about whether colchicine influences overall mortality or reduces the need for procedures such as coronary revascularization. The trials also did not determine whether the drug improves quality of life or shortens hospital stays. The authors emphasize that more research is required to address these gaps and fully establish colchicine's role in cardiovascular disease management.
