Colchicine efficacy and safety for the treatment of cardiovascular diseases.
Adverse events
Atrial fibrillation
Colchicine
Coronary artery disease
Heart failure
Pericarditis
Journal
Internal and emergency medicine
ISSN: 1970-9366
Titre abrégé: Intern Emerg Med
Pays: Italy
ID NLM: 101263418
Informations de publication
Date de publication:
Sep 2021
Sep 2021
Historique:
received:
10
11
2020
accepted:
22
01
2021
pubmed:
12
3
2021
medline:
27
10
2021
entrez:
11
3
2021
Statut:
ppublish
Résumé
The emerging role of colchicine in the treatment of cardiovascular diseases is a strong demand for a comprehensive understanding of its efficacy and safety. This meta-analysis and systematic review aimed to study the efficacy in the reduction of adverse cardiovascular outcomes (CO), and the risk of colchicine-related adverse events (CRAEs). Fourteen thousand and nine eighty three patients from 22 randomized controlled trials (RCTs) were included, 9 in patients with coronary artery disease-CAD, 9 in patients with pericarditis, 4 in patients with atrial fibrillation-AF or heart failure. Colchicine was efficacious in the reduction of adverse CO across different settings: pericardial diseases (reduced risk of recurrent pericarditis, 17.6% vs. 35%, RR 0.50, 95% CI 0.41-0.61), CAD (reduced risk of cardiac death, myocardial infarction, stroke,coronary revascularization or hospitalization, 6.1% vs. 8.5%, RR 0.73, 95% CI 0.64-0.83), AF (reduced risk of arrhythmia recurrence, 14.2% vs. 22.7%, RR 0.62, 95% CI 0.44-0.88). Colchicine was associated with increased risk of gastrointestinal CRAEs (11.2% vs. 8.8%, RR 1.87, 95% CI 1.41-2.47) and drug discontinuation (5.4% vs. 3.7%, RR 1.58, 95% CI 1.25-1.99). In both cases, the risk was proportional to the daily dose or duration of treatment, possibly due to early drug discontinuation or tolerance. Other CRAEs (muscle-related, liver,hematologic,cutaneous, infections) were not increased by colchicine, as long as all-cause death (2.2% vs. 1.9%, RR 1.11, 95% CI 0.79-1.54) or non-cardiovascular death (1.5% vs. 1%, RR 1.43, 95% CI 0.93-2.19). Colchicine is efficacious and safe for the treatment of cardiovascular diseases. The risk of gastrointestinal CRAEs and drug discontinuation is not significant if colchicine is used at lower doses (0.5 mg daily) or for longer periods of time (> 6 months).
Identifiants
pubmed: 33704674
doi: 10.1007/s11739-021-02654-7
pii: 10.1007/s11739-021-02654-7
pmc: PMC7947153
doi:
Substances chimiques
Tubulin Modulators
0
Colchicine
SML2Y3J35T
Types de publication
Journal Article
Review
Langues
eng
Sous-ensembles de citation
IM
Pagination
1691-1700Informations de copyright
© 2021. Società Italiana di Medicina Interna (SIMI).
Références
Pharmacotherapy. 2020 Jun;40(6):575-583
pubmed: 32259308
Am J Physiol Heart Circ Physiol. 2006 Sep;291(3):H1003-14
pubmed: 16679401
Circulation. 2011 Nov 22;124(21):2290-5
pubmed: 22090167
Ann Intern Med. 2011 Oct 4;155(7):409-14
pubmed: 21873705
J Cardiovasc Med (Hagerstown). 2020 Sep;21(9):625-629
pubmed: 32658005
Circ J. 2017 Jul 25;81(8):1174-1182
pubmed: 28420825
JACC Heart Fail. 2014 Apr;2(2):131-7
pubmed: 24720919
Clin Nephrol. 2016 Aug;86(2):100-5
pubmed: 26249546
Clin Toxicol (Phila). 2010 Jun;48(5):407-14
pubmed: 20586571
Am J Cardiol. 2015 May 15;115(10):1376-81
pubmed: 25784519
Lancet. 2014 Jun 28;383(9936):2232-7
pubmed: 24694983
Circulation. 2020 Nov 17;142(20):1890-1900
pubmed: 32862667
Heart. 2020 Oct;106(20):1555-1560
pubmed: 32611559
Rev Esp Cardiol (Engl Ed). 2019 Sep;72(9):709-716
pubmed: 30683494
PLoS Med. 2009 Jul 21;6(7):e1000100
pubmed: 19621070
J Am Coll Cardiol. 1992 Jun;19(7):1597-600
pubmed: 1593057
N Engl J Med. 2019 Dec 26;381(26):2497-2505
pubmed: 31733140
Cell Biol Int. 2018 Aug;42(8):1079-1084
pubmed: 29762881
N Engl J Med. 1986 Apr 17;314(16):1001-5
pubmed: 3515182
Dig Dis Sci. 2020 Jan;65(1):132-140
pubmed: 31312993
Arch Intern Med. 2005 Sep 26;165(17):1987-91
pubmed: 16186468
Eur J Cardiothorac Surg. 2018 May 1;53(5):945-951
pubmed: 29237033
J Am Coll Cardiol. 2012 Oct 30;60(18):1790-6
pubmed: 23040570
N Engl J Med. 1987 Jun 18;316(25):1562-8
pubmed: 3035372
Circulation. 2020 Nov 17;142(20):1996-1998
pubmed: 32864998
J Am Coll Cardiol. 2013 Apr 23;61(16):1679-85
pubmed: 23500260
Eur Heart J. 2015 Nov 7;36(42):2921-2964
pubmed: 26320112
J Thromb Thrombolysis. 2012 Jan;33(1):88-94
pubmed: 21918905
Heart. 2020 Dec 24;:
pubmed: 33361397
Circulation. 2015 Oct 13;132(15):1395-403
pubmed: 26265659
Curr Pharm Des. 2018;24(6):654-658
pubmed: 29336251
J Inflamm Res. 2018 Sep 25;11:359-374
pubmed: 30288079
N Engl J Med. 2013 Oct 17;369(16):1522-8
pubmed: 23992557
Cardiovasc J Afr. 2016 Nov/Dec;27(6):350-355
pubmed: 27965998
Rheumatology (Oxford). 2018 Jan 1;57(suppl_1):i4-i11
pubmed: 29272515
N Engl J Med. 2020 Nov 5;383(19):1838-1847
pubmed: 32865380
Curr Drug Targets Inflamm Allergy. 2005 Feb;4(1):117-24
pubmed: 15720245
J Cardiovasc Med (Hagerstown). 2021 Jan;22(1):1-8
pubmed: 32858634
N Engl J Med. 2017 Sep 21;377(12):1119-1131
pubmed: 28845751
Circ Cardiovasc Interv. 2020 Apr;13(4):e008717
pubmed: 32295417
J Cardiovasc Med (Hagerstown). 2020 Jul;21(7):465-466
pubmed: 32487869
Rheumatol Int. 2007 Jun;27(8):763-5
pubmed: 17177066
Circulation. 2005 Sep 27;112(13):2012-6
pubmed: 16186437
Emerg Med J. 2002 May;19(3):265-7
pubmed: 11971849
Am Heart J. 2016 Aug;178:102-7
pubmed: 27502857
J Cell Biol. 1965 Apr;25:SUPPL:145-60
pubmed: 14342828
JAMA. 2020 Oct 27;324(16):1599
pubmed: 33107942
Med Res Rev. 2008 Jan;28(1):155-83
pubmed: 17464966
JAMA. 2014 Sep 10;312(10):1016-23
pubmed: 25172965
Semin Arthritis Rheum. 2017 Aug;47(1):115-120
pubmed: 28413100