Colchicine efficacy and safety for the treatment of cardiovascular diseases

AbstractThe emerging role of colchicine in the treatment of cardiovascular diseases is a strong demand for a comprehensive understanding of its efficacy and safety. This meta-analysis and systematic review aimed to study the efficacy in the reduction of adverse cardiovascular outcomes (CO), and the risk of colchicine-related adverse events (CRAEs). Fourteen thousand and nine eighty three patients from 22 randomized controlled trials (RCTs) were included, 9 in patients with coronary artery disease —CAD, 9 in patients with pericarditis, 4 in patients with atrial fibrillation—AF or heart failure. Colchicine was efficacious in the reduction of adverse CO across different settings: pericardial diseases (reduced risk of recurrent pericarditis, 17.6% vs. 35%, RR 0.50, 95% CI 0.41–0.61), CAD ( reduced risk of cardiac death, myocardial infarction, stroke,coronary revascularization or hospitalization, 6.1% vs. 8.5%, RR 0.73, 95% CI 0.64–0.83), AF (reduced risk of arrhythmia recurrence, 14.2% vs. 22.7%, RR 0.62, 95% CI 0.44–0.88). Colchicine was associated with increased risk of gastroin testinal CRAEs (11.2% vs. 8.8%, RR 1.87, 95% CI 1.41–2.47) and drug discontinuation (5.4% vs. 3.7%, RR 1.58, 95% CI 1.25–1.99). In both cases, the risk was proportional to the daily dose or duration of treatment, possibly due to early drug discontinuation or tolerance. Other CRAEs (muscle-relate d, liver,hematologic,cutaneous, infections) were not increased by colchicine, as long as all-ca...
Source: Internal and Emergency Medicine - Category: Emergency Medicine Source Type: research