Cheap gout drug may slash heart attack and stroke risk

Researchers evaluated the impact of taking small doses of colchicine, a standard gout treatment, and reported no rise in serious side effects.

Cardiovascular disease is often linked to long-term, low-level inflammation that increases the likelihood of repeat events such as heart attacks and strokes. Because colchicine reduces inflammation, it has emerged as a potentially useful option for people living with heart disease.

A promising effect on cardiovascular risk

The review assessed 12 randomized controlled trials that followed nearly 23,000 individuals with a history of heart disease, heart attack or stroke. Participants took colchicine for at least six months, usually at doses of 0.5 mg once or twice daily. About 80% of those enrolled were male (~80%), and their average age ranged from 57 to 74 years. Half received colchicine, while the rest were given either a placebo or no added medication on top of their typical care.

People taking low-dose colchicine experienced fewer heart attacks and strokes overall. For every 1,000 individuals treated, 9 heart attacks and 8 strokes were avoided compared with those who did not receive the drug. No serious adverse events were seen, although mild and short-lived stomach or digestive discomfort was more common among colchicine users.

"Among 200 people with cardiovascular disease -- where we would normally expect around seven heart attacks and four strokes -- using low-dose colchicine could prevent about two of each," says Dr. Ramin Ebrahimi, co-lead author from the University Medicine Greifswald, Germany. "Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk."

A new use for a long-established medicine

Since cardiovascular diseases remain the leading cause of death worldwide, colchicine offers a potentially affordable and widely available strategy for preventing additional heart problems in high-risk patients.

"These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use," says Lars Hemkens, senior author from the University of Bern, Switzerland. "It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks."

Questions still remain about whether colchicine influences overall mortality or reduces the need for procedures such as coronary revascularization. The trials also did not determine whether the drug improves quality of life or shortens hospital stays. The authors emphasize that more research is required to address these gaps.