CMAAO Coronavirus Facts and Myth Buster: Colchicine |
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CMAAO Coronavirus Facts and Myth Buster: Colchicine
Dr KK Aggarwal,  13 September 2020
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With input from Dr Monica Vasudev

Colchicine Reduces Risk of Major Cardiovascular Events in Patients with CAD

DG alerts: A study presented at the Virtual 2020 European Society of Cardiology (ESC) Congress revealed that colchicine could potentially decrease the risk of major cardiovascular events in patients with chronic coronary artery disease.Low-dose colchicine was tolerated over the long-term and led to significant reduction in the risk of the primary endpoint by nearly one-third. The benefits were evident soon after therapy initiation, accumulating over time, and were observed in patients already taking other effective prevention therapies.The LODOCO2 study included patients aged 35 to 82 years with proven coronary disease, but no advanced renal disease, heart failure or severe valvular heart disease. In the first phase, patients were administered colchicine 0.5 mg/day for 30 days. Those who tolerated (91.3%) the medication, were clinically stable, and wished to continue to the second phase were randomly allocated to receive colchicine (n = 2,762) or placebo (n = 2,760). Most patients in both the study arms were taking medications at baseline, including single antiplatelet therapy (colchicine arm, 66.9% vs 67.1% for placebo), dual antiplatelet therapy (23.1% vs 23.3%), statins (93.9% vs 96.6%), beta-blockers (61.3% vs 62.9%), renin angiotensin inhibitors (72.2% vs 71.2%), calcium-channel blockers (22.9% vs 22.1%), and anticoagulants (12.4% vs 12.0%).The primary composite endpoint of cardiovascular death, myocardial infarction (MI), ischemic stroke, or ischemia-driven coronary revascularization was evident in 187 patients in the colchicine group compared to 264 in the placebo group.

A secondary composite endpoint of cardiovascular death, MI, or ischemic stroke was noted in 4.2% of patients in the colchicine group compared to 5.7% of patients in the placebo group. Other secondary composite endpoints also favored the colchicine arm, including MI or ischemia-driven coronary revascularisation (5.6% vs 8.1%) and cardiovascular death or MI (3.6% vs 5.0%).Serious adverse events in the colchicine and placebo arms, respectively, included hospitalization for gastrointestinal issues (1.9% vs 1.8%), hospitalization for pneumonia (1.7% vs 2.0%), hospitalization for infection (5.0% vs 5.2%), and diagnosis of new cancer (4.3% vs 4.4%).Mechanism: Interleukin 1

Comments: It may have a role on post-COVID phase of illness

 

Dr KK Aggarwal

President CMAAO, HCFI and Past National President IMA

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