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Efficacy and safety of colchicine in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials

Bytyçi, I, Bajraktari, G, Penson, P, Henein, M and Banach, M Efficacy and safety of colchicine in patients with coronary artery disease: a systematic review and meta-analysis of randomized controlled trials. British Journal of Clinical Pharmacology. ISSN 0306-5251 (Accepted)

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Abstract

Background: Inflammation plays a central role in the pathogenesis and clinical manifestations of atherosclerosis. Randomized controlled trials (RCTs) have investigated the potential benefit of colchicine in reducing cardiovascular events (CE) in patients with coronary artery disease (CAD) but produced conflicting results. The aim of this meta-analysis was to evaluate the efficacy and safety of colchicine in patients with CAD.
Methods: We systematically searched selected electronic databases from inception until 10th December 2020. Primary clinical endpoints were: major adverse cardiac events (MACE), allcause mortality, cardio-vascular (CV) mortality, recurrent myocardial infarction (MI), stroke, hospitalization and adverse medication effects. Secondary endpoints were short-term effect of colchicine on inflammatory markers.
Results: Twelve RCTs with a total of 13,073 patients with CAD (colchicine n=6351 and placebo n=6722) were included in the meta-analysis. At mean follow-up of 22.5 months, the colchicine group had lower risk of MACE (6.20% vs. 8.87%; p<0.001), recurrent MI (3.41% vs. 4.41%; p=0.005), stroke (0.40% vs. 0.90%; p=0.002) and hospitalization due to CE (0.90% vs. 2.87%; p=0.02) compared to the control group. The two patient groups had similar risk for all-cause mortality (2.08% vs. 1.88%; p=0.82) and CV mortality (0.71% vs. 1.01%; p=0.38). Colchicine significantly reduced hs-CRP (-4.25, p=0.001) compared to controls but did not significantly affect IL-β1 and IL-18 levels.
Conclusions: Colchicine reduced cardiovascular events and inflammatory markers, hs-CRP and IL-6, in patients with coronary disease compared to controls. Its impact on cardiovascular and all-cause mortality requires further investigation.

Item Type: Article
Uncontrolled Keywords: 1115 Pharmacology and Pharmaceutical Sciences
Subjects: R Medicine > R Medicine (General)
R Medicine > RM Therapeutics. Pharmacology
Divisions: Pharmacy & Biomolecular Sciences
Publisher: Wiley
Date Deposited: 18 Aug 2021 09:01
Last Modified: 04 Sep 2021 05:08
URI: https://researchonline.ljmu.ac.uk/id/eprint/15380

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