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Colchicine - new horizons for an ancient drug. Review based on the highest hierarchy of evidence.
Schattner, Ami.
  • Schattner A; The Faculty of Medicine, Hebrew University and Hadassah Medical School, Jerusalem, Israel. Electronic address: amischatt@gmail.com.
Eur J Intern Med ; 96: 34-41, 2022 02.
Article in English | MEDLINE | ID: covidwho-1670444
ABSTRACT
Colchicine is an old, inexpensive, and relatively safe anti-inflammatory drug traditionally used in gout and over the last 50 years in familial Mediterranean fever. A search of all high-hierarchy studies (randomized controlled trials [RCTs], systematic reviews and meta-analysis of RCTs) over the last 20 years revealed myriad other evidence-based applications. Colchicine seems efficacious in the treatment of acute pericarditis and prevention of recurrences and in the prevention of postcardiac injury syndrome and atrial fibrillation following cardiac surgery or percutaneous interventions. In patients already fully treated with statins and antiplatelet agents following acute coronary syndromes or stable coronary disease, adding low-dose colchicine achieved secondary prevention of major cardiovascular events (myocardial infarction, stroke, or cardiovascular death) with pooled risk reduction 0.75. Colchicine may also be useful in Behcet's syndrome and most recently, in improving outcomes of COVID-19 infection. Colchicine in the low doses used in most trials (≤ 1 mg/d) was generally safe and well-tolerated, excepting diarrhea (approximately 10%) which sometimes led to drug discontinuation. Further RCTs are required to confirm these results, and will likely lead to expanding indications for low-dose colchicine. Increasing numbers of patients will be treated with colchicine in the near future, with improved health outcomes, as long as basic caveats are heeded.
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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Acute Coronary Syndrome / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article

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Full text: Available Collection: International databases Database: MEDLINE Main subject: Pharmaceutical Preparations / Acute Coronary Syndrome / COVID-19 Type of study: Experimental Studies / Prognostic study / Randomized controlled trials / Reviews / Systematic review/Meta Analysis Limits: Humans Language: English Journal: Eur J Intern Med Journal subject: Internal Medicine Year: 2022 Document Type: Article