User:Zeynep Naz Efe
Colchicine Use In Cardiovascular Disease[1]
Colchicine is one of the ancient drugs which has been using for inflammation and various field of medicine. It is FDA approved drug for acute treatment of pericarditis, gout and Familial Mediterranean Fever (FMF). For the last 20 years, it started to use for decrease the inflammation among the cardiovascular patients, especially post-MI. There are multiple controversial ideas about the efficiency and side-effects of the medication itself, but the most of the trials have been done in favor of the colchicine. However, one of the latest studies (Clear synergy-OASIS 9), showed directly opposite. Here is the list of the most important and largest studies have been done about colchicine and it's cardiovascular affect:
- COLCOT Trial[2]: Published in 2019, which consists approximately five thousand patients. The patients are followed up for two years. Results are showing significant drop of post-MI cardiovascular death, recurrent MI and strokes. Also as post-MI complications it has been shown that colchicine prevents recurrent unstable angina hospitalizations.
- LoDoCo Trials (1-2[3]) First trial started in 2015 and the second established in 2020, ran among five thousand chronic coronary syndrome patients. The outcomes are quite similar to COLCOT trial's. However there is no significant difference found in the death of non-cardiac complications. LoDoCo trials focused on chronic patients.
- Clear Synergy (OASIS 7[4]): It was published in November 2024. The study has been done to investigate the effect of low dose colchicine and spironolactone on acute MI patients status post PCI. The study showed that colchicine has no significant effect to prevent secondary cardiovascular events. Also same outcomes was seen for spironolactone, which is one of the cobble stone medications in GDMT for heart failure. There are some important environmental factors which needs to be emphasized for the outcomes of this study. First, the study includes mostly acute and unstable patients, which could be trigger the different outcomes. Secondly, the study was started in 2019-2020, which COVID-19 pandemic effected all the health system in the world. At that time, we know that patients had issues to reach the hospital on time, there were delays and schedule changes unfortunately. On the top of that, as we know, COVID-19 increase the thrombotic activity, which can trigger cardiac events despite the medications especially on vulnerable cardiac patients.
All the studies shown that colchicine has some inevitable side effects as diarrhea (the most common), nausea, fatigue, pancytopenia (rarely).
Despite there are controversial thesis, low dose colchicine (0.5 mg daily) is still one of the most used medications to decrease cardiovascular inflammation in the lifgt of evidence based medicine practice.
- ↑ Karpuz, H., & Efe, Z. N. (2025). Inflammation and Cardiovascular Diseases: Colchicine, a Promising Journey. Turkiye Klinikleri
- ↑ Tardif, J. C., Bouabdallaoui, N., Zahradka, P., & al., e. (2020). Colchicine for Secondary Prevention of Cardiovascular Disease in High-Risk Patients. New England Journal of Medicine, 383(19), 1828-1838. https://doi.org/10.1056/NEJMoa2021372
- ↑ Kashani, A., Baghery, M. M., & al., e. (2020). Low-dose Colchicine for the Prevention of Cardiovascular Events in Patients with Coronary Artery Disease: A Randomized Clinical Trial. Journal of the American Medical Association (JAMA), 324(23), 2323-2330. https://doi.org/10.1001/jama.2020.22032
- ↑ Tardif, J. C., Ponikowski, P., & al., e. (2021). Colchicine in Acute Coronary Syndrome: Results of the OASIS-7 Trial. New England Journal of Medicine, 384(12), 1188-1198. https://doi.org/10.1056/NEJMoa2029546