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Colchicine as an anti-inflammatory and cardioprotective agent

Armen Yuri Gasparyan1, Lilit Ayvazyan2, Marlen Yessirkepov3

  • 1a 1 Dudley Group NHS Foundation Trust (Teaching Trust of University of Birmingham), Russells Hall Hospital, Departments of Rheumatology and Research & Development , DY1 2HQ, Dudley, UK +44 138 424 4842 ; +44 138 424 4808 ; a.gasparyan@gmail.com.

Expert Opinion on Drug Metabolism & Toxicology
|August 5, 2015
PubMed

Insights

Colchicine effectively treats neutrophilic disorders and shows promise in cardiovascular conditions like pericarditis and myocardial ischemia by targeting inflammation. Careful dosing and monitoring are essential to manage side effects and toxicity.

Area of Science:

  • Cardiovascular Medicine
  • Rheumatology
  • Pharmacology

Background:

  • Colchicine is a well-established treatment for neutrophilic disorders including familial Mediterranean fever (FMF), Behçet disease (BD), and gout.
  • There is increasing research interest in the cardiovascular effects of colchicine.

Purpose of the Study:

  • To review the therapeutic applications of colchicine in cardiovascular disorders.
  • To summarize the mechanisms of action, efficacy, and safety of colchicine in cardiovascular and rheumatic diseases.

Main Methods:

  • A comprehensive literature search of MEDLINE/PubMed was conducted for English articles published between January 1972 and June 2015.
  • Keywords included colchicine, inflammation, neutrophils, platelets, and various cardiovascular and rheumatic conditions such as pericarditis, myocardial ischemia, FMF, BD, and gout.

Main Results:

  • Colchicine improves outcomes in pericarditis, myocardial ischemia, and following coronary interventions by targeting neutrophils, endothelial cells, and platelets.
  • Therapeutic doses (0.5-2.5 mg/daily) reduce C-reactive protein, prevent myocardial damage, and maintain normal heart rhythm in rheumatic and cardiovascular disorders.
  • Diarrhea is a common side effect, manageable through dietary changes or temporary cessation of therapy.

Conclusions:

  • Colchicine demonstrates significant benefits in treating pericarditis, myocardial ischemia, and coronary occlusion.
  • The drug's anti-inflammatory properties contribute to its efficacy in both rheumatic and cardiovascular conditions.
  • Risk of colchicine toxicity is elevated by certain medications, comorbidities, and genetic factors, necessitating careful patient selection and monitoring.
Abstract

Keywords:
Behçet diseaseamyloidosiscardiovascular diseasecolchicinefamilial mediterranean fevergoutneutrophilstoxicity

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