Cardiovascular disease (CVD) remains the leading cause of death in the United States. A large new study has concluded that the inflammation-fighting drug colchicine (already a treatment for gout) dramatically reduces the odds of future cardiovascular problems in people who have just survived a heart attack. Colchicine (Colcrys, Mitigare) is a drug that is derived from the autumn crocus and which helps to ease the joint inflammation and pain that characterize gout.
Increasing evidence is suggesting that heart disease is related to inflammation. This is why researchers have tested various anti-inflammatory drugs in heart patients. The latest study, published online on November 16, 2019, by The New England Journal of Medicine, tested colchicine against a placebo in 4,745 people who had experienced a heart attack within the previous month. All of the participants also took standard drugs to treat heart disease, including statins, aspirin, and other clot-preventing drugs.
“Not only did we reduce first events and recurrent events, the drug was well tolerated, the drug is well known, the safety profile is well known, it is inexpensive, and it’s widely available. So it’s only good news for patients,” said chief author Dr. Jean-Claude Tardif, director of the Montreal Heart Institute.
For this trial, Dr. Tardif and his collaborators selected 4,745 heart attack survivors who were an average age of 61. Approximately one-fifth were female, and one-fifth also had diabetes. Over the course of about a year and 10 months, half of the patients received a half-milligram dose of colchicine daily and half received a placebo.
While 7.1 percent of patients in the placebo group died of a cardiovascular event or had a second heart attack, a stroke, or hospitalization, such complications occurred in only 5.5 percent of the colchicine group.
The pill also cut the odds of death from any cardiovascular event by 16 percent, halved the likelihood of patients being hospitalized for coronary bypass or stenting, and reduced the risk of stroke by 74 percent.
Almost all of the participants in both groups were also taking aspirin and a second antiplatelet agent to prevent blood clots, as well as a statin to treat cholesterol. According to Tardiff, the trial demonstrated that colchicine safely added benefit over and above the drugs that patients were already taking.
Researchers expressed great excitement at this discovery as it presents a major new direction to go in the treatment of heart disease that goes beyond cholesterol alone. The study has elicited a response from healthcare providers who can now treat heart disease by not only lowering cholesterol but by aggressively treating inflammation as well.
The present study has only evaluated whether colchicine is effective for treating patients who have already suffered heart attacks. This begs further study regarding the need to investigate the efficacy of colchicine for prevention of heart attacks when used on patients who have not suffered a previous heart attack. Another study suggested that the anti-gout medication allopurinol can also potentially aid in heart attack prevention in heart attack patients.
Tardif states that the drug does come with certain increased risks, such as that of pneumonia, and that it is not prescribed for long-term use. In using the drug for secondary prevention, the side effects are usually acceptable because patients are at such high risk. For these reasons, colchicine’s use may need to be limited. Hopefully, though, these findings will help scientists come up with a much safer drug.