Dr Malik feels this old-Fashioned drug has a place in reducing overall cardiovascular risk.
Colchicine 500micg once a day in addition to standard drugs such as statins, aspirin and blood pressure control reduced risk in patients average age 60-65 in 2 separate trials. Colchicine was associated with a relative risk reduction for cardiovascular death, heart attack, stroke, and coronary revascularization of 23–31% as compared to placebo.
Colchicine Cardiovascular Outcomes Trial (COLCOT) and Low-Dose Colchicine trial (LoDoCo2)] that collectively included over 10 000 participants. Follow-up was up to 5 years, but averaged just over 2 years.
loDoCo2 recruited patients within 30 days of a heart attack. COLCOT recruited patients with chronic coronary heart disease.
The commonest side effect in practice is diarrhoea. At this low dose, it was no more common that in the placebo group.
I will be using this much more frequently now! I use it in pericarditis but will now use it in coronary disease. It will add it to aspirin, statin, ACE inhibitors in these patients.