Colchicine for the Secondary Prevention of Cardiovascular Diseases: A Cumulative-Dose Meta-analysis of Randomized Controlled Trials including 31,397 Subjects Worldwide.

Background: Colchicine has been incorporated into major clinical guidelines for the secondary prevention of cardiovascular disease (CVD). However, recent randomized trials have presented contradictory results. Objective: We aimed to synthesize the current evidence on colchicine in secondary CVD prot...

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Publicado en:American Journal of Cardiovascular Drugs Vol. 26; no. 1; pp. 107 - 121
Autores principales: Li, Hoi-Ying, Cheriyan, Joseph, Chan, Tsz-Kwan, Yiu, Kai-Hang, Tse, Hung-Fat, Wilkinson, Ian B., Chan, Yap-Hang
Formato: meta analysis research systematic review tables/charts Journal Article
Publicado: Springer Nature Jan2026
Acceso en línea:Ver este registro en EBSCOhost
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      dt: Jan2026
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      pub: Springer Nature
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        atl: Colchicine for the Secondary Prevention of Cardiovascular Diseases: A Cumulative-Dose Meta-analysis of Randomized Controlled Trials including 31,397 Subjects Worldwide.
      aug:
        au:
          Li, Hoi-Ying
          Cheriyan, Joseph
          Chan, Tsz-Kwan
          Yiu, Kai-Hang
          Tse, Hung-Fat
          Wilkinson, Ian B.
          Chan, Yap-Hang
        affil: https://ror.org/02zhqgq86 Department of Medicine, School of Clinical Medicine, The University of Hong Kong, K1927C, Queen Mary Hospital, 102 Pokfulam Road, Pok Fu Lam, Hong Kong SAR, China
      sug:
        subj:
          Cardiovascular Diseases Prevention and Control
          Colchicine Therapeutic Use
          Major Adverse Cardiac Events Prevention and Control
          Colchicine Adverse Effects
          Human
          Male
          Female
          Systematic Review
          PubMed
          Embase
          Cochrane Library
          Descriptive Statistics
          Checklists
          Meta Analysis
          Data Analysis Software
          Odds Ratio
          Confidence Intervals
          C-Reactive Protein
          Funding Source
          Male
          Female
      ab: Background: Colchicine has been incorporated into major clinical guidelines for the secondary prevention of cardiovascular disease (CVD). However, recent randomized trials have presented contradictory results. Objective: We aimed to synthesize the current evidence on colchicine in secondary CVD protection, using a cumulative-dose approach. Methods: We conducted a meta-analysis incorporating all randomized controlled trials (RCTs) globally. RCTs directly comparing colchicine versus placebo/standard care for the secondary prevention of cerebrovascular or coronary vascular disease were included. Odds ratios (OR) were derived for the primary outcome, defined as the prospective occurrence of major adverse cardiovascular events (MACE). Secondary outcomes included mortality, individual components of MACE, C-reactive protein, and adverse effects. Results: In total, 14 RCTs including 31,397 participants were included. Colchicine significantly reduced MACE (OR 0.80; 95% confidence interval [CI] 0.68–0.94) in both acute atherothrombotic CVD and all CVD (OR 0.72; 95% CI 0.60–0.86) and resulted in significant prospective reductions in C-reactive protein. The threshold effect was apparent, with a protective benefit of colchicine against MACE at higher cumulative exposure ≥ 90 mg-days (OR 0.66; 95% CI 0.52–0.84). Colchicine resulted in no differences in cardiovascular or non-cardiovascular mortality. Conclusions: Colchicine significantly reduces MACE in both acute atherothrombotic and all CVD across multiple ethnicities, with a threshold protective effect that clinically corresponds to treatment with 0.5 mg daily for at least 6 months. Importantly, there was no signal of increased all-cause mortality. Registration: PROSPERO identifier no. CRD420251003142.
      pubtype: Academic Journal
      doctype:
        meta analysis
        research
        systematic review
        tables/charts
        Journal Article
      ougenre: Article
    language: English
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