A randomized, controlled, double-blind trial showed that 0.5 mg of colchicine once daily significantly reduced cardiovascular disease (CVD) events in patients with chronic coronary disease in Australia and the Netherlands. The trial included 5522 patients, >80% male, 35 to 82 years of age (2762 assigned to colchicine and 2760 to placebo group). The median duration of follow-up was 28.6 months. A primary end-point event (a composite of CVD death, spontaneous myocardial infarction [MI], ischemic stroke, or ischemia-driven coronary revascularization) occurred in 6.8% and 9.6% of patients, respectively, in the colchicine and the placebo group (incidence, 2.5 vs. 3.6 events per 100 person-years; hazard ratio [HR], 0.69). A key secondary end-point event (a composite of CVD death, spontaneous MI, or ischemic stroke) occurred in 4.2% and 5.7% of patients, respectively, in the colchicine and in the placebo group (incidence, 1.5 vs. 2.1 events per 100 person-years; HR 0.72). The incidence rates of spontaneous MI or ischemia-driven coronary revascularization (composite end point), CVD death or spontaneous MI (composite end point), ischemia-driven coronary revascularization, and spontaneous MI were also significantly lower with colchicine than with placebo. However, the incidence of death from non-CVD causes was higher in the colchicine group than in the placebo group (incidence, 0.7 vs. 0.5 events per 100 person-years; HR 1.51). For the 15.4% who had started the 30-day run-in period but did not undergo randomization, the most common reason was gastrointestinal upset. The magnitude of benefit of low-dose colchicine in the trial is consistent with that shown in previous trials of anti-inflammatory therapy and in other secondary prevention therapies, including lipid-lowering, blood pressure–lowering, and antithrombotic therapies, and a benefit was observed in the patients who were already receiving therapy with these agents. Colchicine has broad anti-inflammatory effects and has been used for gout and acute pericarditis. Source: https://www.nejm.org/
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