Colchicine and residual inflammation: an old drug with a new trick

Editorials
Kayla Chiew
23/02/2024

Take home messages

  • The United States Food and Drug Administration recently approved colchicine for the secondary prevention of cardiovascular events in June 2023.
  • This is the first inflammation-targeted therapy licensed in atherosclerotic cardiovascular disease.
  • Clinical application of anti-inflammatory medications has been limited by risk of serious infections. Low dose 0.5mg colchicine daily appears to strike the balance of systemic inflammation suppression without increasing infection risk.
  • The application of low dose colchicine in a wide range of atherosclerotic diseases is currently an active field of research.
Introduction

Colchicine, a drug most familiar to cardiologists for treating acute pericarditis, is steadily gaining recognition for its potential role in treating ischaemic heart disease. The recent United States Food and Drug Administration (US FDA) approval of low dose colchicine for the secondary prevention of cardiovascular events in those with established atherosclerotic disease marks a new era in preventative cardiology as the first licensed therapy to target inflammation(1). Whilst the concept of inflammation driving atherosclerosis is not novel, treatments directed at suppressing inflammation have yielded inconsistent results, with translation to clinical practice further hindered by signals of harm from serious infections. Herein we discuss the evidence behind colchicine and the upcoming landscape of inflammation-targeted therapies in cardiovascular disease.