Colchicine approved by FDA to prevent cardiac events

This summer, the FDA approved low dose colchicine to help prevent cardiac events. Colchicine is a drug that has been used to treat gout and Familial Mediterranean Fever (FMF) for many years. People on this medication for these conditions were noted to have lower rates of heart disease.¹ So studies were done to see if colchicine could independently reduce the risk of heart attacks and other cardiovascular events.

The LoDoCo study enrolled over 500 people and followed them for 3 years. It found less than a third the rate of certain cardiovascular events in those who took colchicine as compared to those who did not.² The LoDoCo2 study was then done and published in the New England Journal of Medicine. Researchers enrolled over 5,000 people and followed them for 5 years. The study showed a 31% reduction in another cardiac episode in people already taking aspirin and a statin (such as Lipitor or Crestor).³ These results are highly impressive.

Colchicine works by reducing inflammation. Evidence is mounting that high cholesterol is not the only risk factor for heart disease. Inflammation, which can be measured by a C Reactive Protein (CRP) also seems to play a role. If your CRP is high you may wish to talk to your doctor about whether colchicine might be a good choice for you. Other steps you can take to reduce inflammation (and therefore your CRP) include quitting smoking, losing weight, , exercising, eating a Mediterranean diet or at least eating less processed food and sugar.

1 - Crittenden DB, Lehmann RA, Schneck L, Keenan RT, Shah B, Greenberg JD, Cronstein BN, Sedlis SP, Pillinger MH. Colchicine use is associated with decreased prevalence of myocardial infarction in patients with gout. J Rheumatol. 2012 Jul;39(7):1458-64. doi: 10.3899/jrheum.111533.

2 - Nidorf S, Eikelboom J, Budgeon C, et al. Low-Dose Colchicine for Secondary Prevention of Cardiovascular Disease. J Am Coll Cardiol. 2013 Jan, 61 (4) 404–410. doi.org/10.1016/j.jacc.2012.10.027.

3 - Nidorf S, Fiolet A, Mosterd A, Eikelboom JW, Schut A, Opstal T, The S, Xu XF, Ireland MA, Lenderink T, Latchem Pieter Hoogslag P, et al. Colchicine in Patients with Chronic Coronary Disease. N Engl J Med 2020; 383:1838-1847. doi.org/10.1056/NEJMoa2021372.