Drug repurposing? Cardiovascular effect of colchicine on patients with coronary artery disease: A systematic review and meta-analysis.

Background: Patients with coronary artery disease (CAD) are at high risk of atherosclerotic events. The aim of this meta-analysis is to evaluate the cardiovascular protective effect of colchicine on patients with CAD.

Methods: In this systematic review and meta-analysis, we searched PubMed and Embase for studies published until April 28, 2020. We included studies that reported the incidence of myocardial infarction (MI), restenosis after percutaneous coronary intervention (PCI), and mortality for CAD patients within colchicine and control (placebo or usual care) groups. A random-effects meta-analysis model was then applied.

Results: Ten eligible trials were identified, including 6398 patients (3248 received colchicine while 3150 were controls). The risk of composite events of MI and restenosis after PCI was significantly decreased with colchicine treatment [odds ratio (OR) 0.48, 95% confidence interval (CI) 0.28-0.79]. We found a similar trend of lowered risk of MI in the colchicine group, although without statistical significance (OR 0.41, 95% CI 0.16-1.08). The risk of restenosis after PCI also decreased significantly with colchicine treatment (OR 0.46, 95% CI 0.23-0.92). There was no significant difference in all-cause mortality between the two groups (OR 0.80, 95% CI 0.56-1.15). The included patients had significantly higher risks of gastrointestinal (GI) events with colchicine treatment.

Conclusions: This meta-analysis shows that there is a decreased composite risk of MI and restenosis after PCI with the use of colchicine in patients with CAD. However, colchicine did not appear beneficial for all-cause mortality, and it led to a higher risk of GI events.