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Colchicine in Patients with Chronic Coronary Disease
Open accessAbstract
BACKGROUND: Evidence from a recent trial has shown that the antiinflammatory effects of colchicine reduce the risk of cardiovascular events in patients with recent myocardial infarction, but evidence of such a risk reduction in patients with chronic coronary disease is limited. METHODS: In a randomized, controlled, double-blind trial, we assigned patients with chronic coronary disease to receive 0.5 mg of colchicine once daily or matching placebo. The primary end point was a composite of cardiovascular death, spontaneous (nonprocedural) myocardial infarction, ischemic stroke, or ischemia-driven coronary revascularization. The key secondary end point was a composite of cardiovascular death, spontaneous myocardial infarction, or ischemic stroke. RESULTS: A total of 5522 patients underwent randomization; 2762 were assigned to the colchicine group and 2760 to the placebo group. The median duration of follow-up was 28.6 months. A primary end-point event occurred in 187 patients (6.8%) in the colchicine group and in 264 patients (9.6%) in the placebo group (incidence, 2.5 vs. 3.6 events per 100 person-years; hazard ratio, 0.69; 95% confidence interval [CI], 0.57 to 0.83; P<0.001). A key secondary end-point event occurred in 115 patients (4.2%) in the colchicine group and in 157 patients (5.7%) in the placebo group (incidence, 1.5 vs. 2.1 events per 100 person-years; hazard ratio, 0.72; 95% CI, 0.57 to 0.92; P = 0.007). The incidence rates of spontaneous myocardial infarction or ischemia-driven coronary revascularization (composite end point), cardiovascular death or spontaneous myocardial infarction (composite end point), ischemia-driven coronary revascularization, and spontaneous myocardial infarction were also significantly lower with colchicine than with placebo. The incidence of death from noncardiovascular causes was higher in the colchicine group than in the placebo group (incidence, 0.7 vs. 0.5 events per 100 person-years; hazard ratio, 1.51; 95% CI, 0.99 to 2.31). CONCLUSIONS: In a randomized trial involving patients with chronic coronary disease, the risk of cardiovascular events was significantly lower among those who received 0.5 mg of colchicine once daily than among those who received placebo. (Funded by the National Health Medical Research Council of Australia and others; LoDoCo2 Australian New Zealand Clinical Trials Registry number, ACTRN12614000093684.).
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“The efficacy of GLP-1 medications is consistent with actions of other antiinflammatory agents, such as IL-1 antagonists and colchicine, in reducing cardiovascular events (63, 64).”
From Antiinflammatory actions of glucagon-like peptide-1–based therapies beyond metabolic benefits (2025) · cites this paper as [63]
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“The CTTC analysis reported that the benefits of lowering LDL-C level were consistent across a wide spectrum of baseline risk varying from less than 5% to 30% or greater.”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [24]
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“The CTTC analysis showed a 22% reduction in major coronary events for each 38.7-mg/dL (1-mmol/L) decrease in LDL-C level and a 15% reduction in vascular death.”
From Bempedoic Acid for Primary Prevention of Cardiovascular Events in Statin-Intolerant Patients (2023) · cites this paper as [24]
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Kittleson, M. M. (2025) · Annals of Internal Medicine · doi:10.7326/annals-25-03512 · Cited by 10
TNF superfamily molecules in atherosclerosis: mechanistic insights and therapeutic translation
Luo, J., Zhang, J., Xie, Y., Wu, M., Wang, Z., & Ma, D. (2025) · Frontiers in Immunology · doi:10.3389/fimmu.2025.1629577 · Cited by 9
Trimaille, A., Hmadeh, S., Kikuchi, S., Mroueh, A., Carmona, A., Marchandot, B., Beras, F., Truong, D. P., Vu, M. C., Granier, A., et al. (2025) · Journal of the American Heart Association · doi:10.1161/jaha.125.041701 · Cited by 9
“Although several randomized trials have investigated the effectiveness of immunomodulatory drugs for coronary heart disease, including canakinumab 41 and colchicine, 42,43 data on their role in AS remain sparse.”
Filtz, A., Shapiro, M. D., Whelton, P. K., Návar, A. M., Rodríguez, F., Martin, S. S., Gulati, M., Blankstein, R., Ridker, P. M., Bhatt, D. L., et al. (2025) · American Journal of Preventive Cardiology · doi:10.1016/j.ajpc.2025.101357 · Cited by 9
Kraler, S. C., Liberale, L., Tirandi, A., Moriero, M., Wang, Y., Farag, M., Carbone, F., Bertolotto, M. B., Pusterla, V., Ramoni, D., et al. (2025) · European Heart Journal · doi:10.1093/eurheartj/ehaf979 · Cited by 10
“6 Yet, the recently published CLEAR-SYNERGY trial does not support the use of this non-specific anti-inflammatory agent in the acute setting.”
Molecular Mechanisms Underlying Atherosclerosis and Current Advances in Targeted Therapeutics
Zhu, B. J. (2026) · International Journal of Molecular Sciences · doi:10.3390/ijms27020634 · Cited by 11
“Administration of low-dose colchicine inhibits microtubule-dependent activation of the inflammasome and has been associated with a lower incidence of recurrent cardiovascular events in patients following myocardial infarction [158,159].”
Mangaonkar, A. A., Bolton, K. L., & Patnaik, M. M. (2026) · American Journal of Hematology · doi:10.1002/ajh.70205 · Cited by 13
Romeo, F. J., Golino, M., Morello, M., Muro, F. M. D., Moroni, F., Buono, M. G. D., Biondi‐Zoccai, G., & Abbate, A. (2026) · Scientific Reports · doi:10.1038/s41598-026-39691-1 · Cited by 9
“So far, clinical trials have produced mixed evidence, with COLCOT 28 and LoDoCo2 29 trials demonstrating the efficacy of low-dose colchicine (0.5 mg daily) in acute and chronic coronary syndromes whereas the recent CLEAR SYNERGY (OASIS 9) trial, involving over 7,000 patients starting colchicine soon after MI and conti…”
InfluentialZhang, H., Han, X., Pan, T., Zhang, H.-T., Zhong, K. L., Li, Z.-S., Jiang, X., Pan, J., & Wang, D. (2022) · BMJ Open · doi:10.1136/bmjopen-2021-050577 · Cited by 9
Straat, M. E., Martínez‐Téllez, B., Janssen, L. G. M., van Veen, S., van Eenige, R., Kharagjitsing, A. V., van den Berg, S. A. A., de Rijke, Y. B., Haks, M. C., Rensen, P. C. N., et al. (2022) · Journal of Thermal Biology · doi:10.1016/j.jtherbio.2022.103259 · Cited by 10
Kitada, R., Otsuka, K., & Fukuda, D. (2023) · Frontiers in Cardiovascular Medicine · doi:10.3389/fcvm.2023.1095806 · Cited by 11
“COLCOT and LoDoCo2 are two large clinical trials that provided and confirmed the hypothesis that repurposed colchicine is an effective anti-inflammatory agent in atherosclerosis (123, 125).”
BackgroundTargeting residual cardiovascular risk in the statin era: cholesterol or inflammation?
Liuzzo, G., & Patrono, C. (2023) · European Heart Journal · doi:10.1093/eurheartj/ehad241 · Cited by 9
Abela, G. S., Katkoori, V. R., Pathak, D. R., Bumpers, H. L., Leja, M. J., Abideen, Z. U., Boumegouas, M., Perry, D. J., Al-Janadi, A., Richard, J. E., et al. (2023) · American Heart Journal Plus Cardiology Research and Practice · doi:10.1016/j.ahjo.2023.100317 · Cited by 9
“Also, recently, colchicine was approved for prevention treatment of patients with existing and those with multiple risk factors for cardiovascular disease based on the Lodoco study [35,36].”
BackgroundEdsfeldt, A., Gonçalves, I., Vigren, I., Jovanović, A., Engström, G., Shore, A. C., Natali, A., Khan, F., & Nilsson, J. Å. (2023) · Vascular Pharmacology · doi:10.1016/j.vph.2023.107214 · Cited by 9
Targeting Pharmacotherapies for Inflammatory and Cardiorenal Endpoints in Kidney Disease
Huck, D. M., Buckley, L. F., Chandraker, A. K., Blankstein, R., & Weber, B. (2023) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000001482 · Cited by 10
“80 There is some evidence that colchicine may be effective for renal endpoints in moderate CKD, including a nested case – control study which found that the colchicine use in stages 3 – 4 CKD was associated with reduced risk of CKD progression.”
BackgroundInfluentialHa, E. T., Yee, A. J., Peterson, S. J., Kobayashi, Y., Sacchi, T. J., Parikh, M., & Brener, S. J. (2023) · Cardiovascular revascularization medicine · doi:10.1016/j.carrev.2023.09.003 · Cited by 9
Su, H., Cao, Y., Chen, Q., Ye, T., Cui, C., Chen, X., Yang, S., Qi, L., Yu, L., Xiong, S., et al. (2023) · Frontiers in Endocrinology · doi:10.3389/fendo.2023.1287855 · Cited by 16
Inflammation as a New Therapeutic Target among Older Patients with Ischemic Heart Disease
Maidana, D., Arroyo-Álvarez, A., Arenas‐Loriente, A., Barreres-Martín, G., Muñoz-Alfonso, C., Bompart, D., Claramunt, F. E., del Burgo, R. B., Guillén, P. L. C., García‐Blas, S., et al. (2024) · Journal of Clinical Medicine · doi:10.3390/jcm13020363 · Cited by 10
A short review on CRP synthesis inhibition in cardiovascular disease
Zaczkiewicz, M., Zimmermann, O., & Torzewski, J. (2024) · Frontiers in Drug Discovery · doi:10.3389/fddsv.2024.1338535 · Cited by 10
Pedersen, G., Dahl, J. N., Rasmussen, L. D., Blavnsfeldt, A. G., Böttcher, S. H., Böttcher, M. H., Nyegaard, M., Nissen, L., & Winther, S. (2024) · Journal of cardiovascular computed tomography · doi:10.1016/j.jcct.2024.06.009 · Cited by 9
Samsonov, M., Bogin, V., Tassell, B. V., & Abbate, A. (2021) · Journal of Translational Medicine · doi:10.1186/s12967-021-02828-z · Cited by 8
“Colchicine has been recently shown to reduce the rate of recurrent cardiovascular events in patients with atherosclerotic disease [30, 31].”
BackgroundMarcusohn, E., Zukermann, R., Kerner, A., Roguin, A., & Kobo, O. M. (2021) · Catheterization and Cardiovascular Interventions · doi:10.1002/ccd.29870 · Cited by 9
“Also, colchicine, a drug which is familiar for decades has shown recently benefit in both acute and chronic coronary artery disease.(18,19) However, other treatment options, such as prednisone,(20) low-dose methotrexate(21) or Losmapimod,(22) did not show benefit in cardiovascular endpoints but did reduce HF incidence…”
BackgroundmiR-24 Alleviates MI/RI by Blocking the S100A8/TLR4/MyD88/NF-kB Pathway
Yang, J., Xiang, Z., Zhang, J., Yang, J., Zhai, Y., Fan, Z., Wang, H., Wu, J., Huang, Y., Xiong, M., et al. (2021) · Journal of Cardiovascular Pharmacology · doi:10.1097/fjc.0000000000001139 · Cited by 9
Chu, C., Chen, Y., Lin, M., Wu, W., Liu, F., Chen, H., Chou, Y., & Sun, C. (2022) · International Journal of Environmental Research and Public Health · doi:10.3390/ijerph19063395 · Cited by 9
“Colchicine is an anti-inflammatory drug with hypoglycemic effects [8,12] and may reduce the risk of T2DM [13].”
BackgroundŠabović, E. K. M., Zorko, M. S., & Janić, M. (2022) · International Journal of Molecular Sciences · doi:10.3390/ijms23126648 · Cited by 10
“However, randomized controlled trials with apremilast did not show an increased risk of MACE [5].”
BackgroundKinlay, S., Sobieszczyk, P. S., Eisenhauer, A. C., Ostrowski, S. J., & Todoran, T. M. (2023) · Vascular Medicine · doi:10.1177/1358863x231174052 · Cited by 9
“01) Critical limb ischemia, n (%) 33 (28) 9 (11) 2.”
InfluentialBeneficiary Effects of Colchicine on Inflammation and Fibrosis in a Mouse Model of Kidney Injury
Landau, D., Shukri, N., Arazi, E., Tobar, A., & Segev, Y. (2023) · The Nephron journals/Nephron journals · doi:10.1159/000531313 · Cited by 9
“Recently, its ef fi cacy has also been shown for the secondary prevention of adverse cardiovascular events [11].”
BackgroundFrydland, M. S., Møgelvang, R., Møller, J. E., Helgestad, O. K. L., Holmvang, L., Mark, P., Jensen, L. O., & Hassager, C. (2021) · Shock · doi:10.1097/shk.0000000000001721 · Cited by 9
“0001 Multiple VD, n (%) 142 (35) 129 (32) 157 (38) 173 (43) 0.”
Effects of colchicine on tissue factor in oxLDL-activated T-lymphocytes
Cirillo, P. L., Conte, S., Pellegrino, G., Barra, G., Palma, R. D., Sugraliyev, A., Golino, P., & Cimmino, G. (2021) · Journal of Thrombosis and Thrombolysis · doi:10.1007/s11239-021-02585-2 · Cited by 9
“Specifically, it has been demonstrated that colchicine administered in addition to statins and other standard therapies for secondary prevention, lead to better outcome in term of cardiovascular events [17, 19].”
BackgroundTargeting of the NLRP3 Inflammasome for early COVID-19Preprint
Marchetti, C., Mould, K. J., Tengesdal, I. W., Janssen, W. J., & Dinarello, C. A. (2021) · bioRxiv (Cold Spring Harbor Laboratory) · doi:10.1101/2021.02.24.432734 · Cited by 9
Parums, D. V. (2021) · Medical Science Monitor · doi:10.12659/msm.935172 · Cited by 9
de Visser, S. J., van den Berg, S., Mosterd, A., & Lo, D. C. (2024) · Drug Discovery Today · doi:10.1016/j.drudis.2024.104096 · Cited by 9
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Conen, D., Popova, E., Wang, M. K., Chan, M. T. V., Landoni, G., Reimer, C. L., Srinathan, S., Cata, J. P., McLean, S. R., Trujillo-Reyes, J. C., et al. (2023) · American Heart Journal · doi:10.1016/j.ahj.2023.01.018 · Cited by 10
Self-citationSystemic inflammatory response in cardiac surgery: possibilities of using colchicine
Diakova, M. L., Shipulin, V. M., Svirko, Y. S., Гусакова, А. М., Podoksenov, Y. K., Олегович, К. Н., & Kozlov, B. N. (2023) · Kardiologiia · doi:10.18087/cardio.2023.7.n2229 · Cited by 8
Merinopoulos, I., Bhalraam, U., Holmes, T. L., Tsampasian, V., Corballis, N. H., Gunawardena, T., Sawh, C., Maart, C., Wistow, T., Ryding, A., et al. (2023) · PLoS ONE · doi:10.1371/journal.pone.0294746 · Cited by 8
Clonal Hematopoiesis from a Diagnostic Perspective: 10 Years of CHIP
Kjær, L., Skov, V., Larsen, M. K., Kristiansen, M. H., Wienecke, T., Cordua, S., Ellervik, C., Langabeer, S. E., & Hasselbalch, H. C. (2024) · Molecular Diagnosis & Therapy · doi:10.1007/s40291-024-00737-7 · Cited by 9
“These anti-inflammatory agents include among others statins [32, 36, 37], colchicine [38], and monoclonal interleukin (IL)-1β antibody therapy (canakinumab) [39].”
Sridhar, V. S., Cosentino, F., Dagogo-Jack, S. E., McGuire, D. K., Pratley, R. E., Cater, N. B., Essex, M. N., Mancuso, J. P., Zhao, Y., & Cherney, D. Z. I. (2024) · Diabetes Obesity and Metabolism · doi:10.1111/dom.15895 · Cited by 9
Cock, E. D., Kautbally, S., Timmermans, F., Bogaerts, K., Hanet, C., Desmet, W. J., Gurné, O., Vranckx, P., Hiltrop, N., Dujardin, K., et al. (2024) · American Heart Journal · doi:10.1016/j.ahj.2024.08.022 · Cited by 8
Recurrent pericarditis in older adults: Clinical and laboratory features and outcome
Bizzi, E., Cavaleri, F., Mascolo, R., Conte, E., Maggiolini, S., Carlini, C. C. D., Maestroni, S., Collini, V., Sicignano, L. L., Verrecchia, E., et al. (2024) · Journal of the American Geriatrics Society · doi:10.1111/jgs.19150 · Cited by 8
“24,25 26 A recent review 27 highlighted how pericardial effusion is practically ubiquitous in isolated pericarditis of viral etiology, affecting all patients, and giving rise to conditions of cardiac tamponade, especially in older adults; in agreement with these findings, we found a higher…”
Metadata
- Authors
- Nidorf, S. M., Fiolet, A. T. L., Mosterd, A., Eikelboom, J. W., Schut, A., Opstal, T. S. J., The, S. H. K., Xu, X.-F., Ireland, M. A., Lenderink, T., Latchem, D., Hoogslag, P., Jerzewski, A., Nierop, P., Whelan, A., Hendriks, R., Swart, H., Schaap, J., Kuijper, A. F. M., van Hessen, M. W. J., Saklani, P., Tan, I., Thompson, A. G., Morton, A., Judkins, C., Bax, W. A., Dirksen, M., Alings, M., Hankey, G. J., Budgeon, C. A., Tijssen, J. G. P., Cornel, J. H., & Thompson, P. L.
- Affiliations
- Sir Charles Gairdner Hospital (AU)
- Gelre Hospitals (NL)
- From GenesisCare Western Australia (S.M.N., X.-F.X., M.A.I., D.L., A.W., R.H., P.S., I.T., A.G.T., A. Morton, P.L.T.), the Heart and Vascular Research Institute (S.M.N., P.L.T.) and the Department of Neurology (G.J.H.), Sir Charles Gairdner Hospital, and the Faculty of Health and Medical Sciences (G.J.H., P.L.T.) and the School of Population and Global Health (C.A.B.), University of Western Australia, Perth, the Department of Cardiology, Fiona Stanley Hospital, Murdoch, WA (C.J.), and the Harry...
- The University of Western Australia (AU)
- Harry Perkins Institute of Medical Research (AU)
- ORCID
- Nidorf, Stefan M.
- Fiolet, Aernoud T.L.
- Mosterd, Arend
- Eikelboom, John W.
- Schut, Astrid
- Opstal, Tjerk S.J.
- Lenderink, Timo
- Schaap, Jeroen
- Kuijper, Aaf F.M.
- Thompson, Angus G.
- Morton, Allison
- Bax, Willem A.
- Dirksen, Maurits
- Alings, Marco
- Hankey, Graeme J.
- Budgeon, Charley A.
- Tijssen, Jan G.P.
- Cornel, Jan H.
- Thompson, Peter L.
- Venue
- New England Journal of Medicine
- Publisher
- Massachusetts Medical Society
- Published
- 2020-11-05
- Volume
- 383
- Issue
- 19
- Pages
- 1838-1847
- ISSN
- 0028-4793 (ISSN-L)
- 1533-4406
- OpenAlex
- W3081761942
- Cited by
- 2,299
- References
- 37
- Citations by year
- 2026: 446 · 2025: 455 · 2024: 388 · 2023: 345 · 2022: 298 · 2021: 311 · 2020: 55
- FWCI
- 155.97
- Type
- journal article
- Language
- en
- Open access
- bronze
- doi.org
- Locations
- New England Journal of Medicine (publishedVersion)
- PubMed (publishedVersion)
- Amsterdam UMC (VU Amsterdam) - Institutional Repository (publishedVersion, other-oa)
- Pure Amsterdam UMC (acceptedVersion, cc-by)
- Radboud Repository (Radboud University) (submittedVersion)
- UWA Profiles and Research Repository (UWA) (submittedVersion)
- Data Archiving and Networked Services (DANS) (submittedVersion)
- Radboud Repository (Radboud University) (submittedVersion, other-oa)
- Data Archiving and Networked Services (DANS) (submittedVersion, other-oa)
- Funders
- the National Health Medical Research Council of Australia (NHMRC project grant APP1088455)
- the Withering Foundation the Netherlands
- the Netherlands Organization for Health Research and Development (Grantnr. 848015014)
- the Netherlands Heart Foundation
- Aspen, Australia
- Teva, Haarlem, Disphar, Baarn and Tiofarma, Oud-Beijerland
- Research Advisory Committee of Sir Charles Gairdner Hospital and Osborne ParkGroup and Charlies Foundation for Research
- Topics
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Acute Myocardial Infarction Research
- Health Sciences › Medicine › Cardiology and Cardiovascular Medicine › Antiplatelet Therapy and Cardiovascular Diseases
- Life Sciences › Immunology and Microbiology › Immunology › Atherosclerosis and Cardiovascular Diseases
- Keywords
- colchicine, stable coronary artery disease, anti-inflammatory therapy, cardiovascular events, myocardial infarction, ischemic stroke, cardiovascular mortality, coronary revascularization, non-cardiovascular mortality, antiplatelet therapy, statins, coronary artery disease, secondary prevention, cardiovascular risk reduction, cardiovascular risk stratification
- MeSH terms
- Aged, Anti-Inflammatory Agents, Cardiovascular Diseases, Chronic Disease, Colchicine, Coronary Disease, Double-Blind Method, Female, Follow-Up Studies, Humans, Male, Middle Aged, Incidence, Proportional Hazards Models, Intention to Treat Analysis
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