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Colchicine and diabetes in patients with chronic coronary artery disease: insights from the LoDoCo2 randomized

Niekbachsh Mohammadnia1, Jan Los1, Tjerk S J Opstal1,2

  • 1Department of Cardiology, Radboudumc, Nijmegen, Netherlands.

Frontiers in Cardiovascular Medicine
|October 23, 2023
PubMed
Abstract

Insights

Colchicine effectively reduces cardiovascular events in patients with chronic coronary artery disease, regardless of diabetes status. Further research is needed to confirm colchicine

Area of Science:

  • Cardiology
  • Endocrinology
  • Pharmacology

Background:

  • Patients with chronic coronary artery disease (CAD) and diabetes mellitus (DM) face elevated cardiovascular risks.
  • Optimal treatments still leave a significant unmet need for novel therapeutic strategies.
  • The Low-Dose Colchicine 2 (LoDoCo2) trial previously established colchicine's efficacy in reducing cardiovascular risk in chronic CAD patients.

Purpose of the Study:

  • To evaluate the efficacy of colchicine in patients with chronic CAD and co-existing DM.
  • To assess the impact of colchicine on the development of new-onset type 2 diabetes mellitus (T2DM).

Main Methods:

  • Analysis of data from the LoDoCo2 trial, which randomized 5,522 patients to placebo or daily colchicine (0.5 mg).
  • Evaluation of treatment effects stratified by diabetes status (presence or absence of T2DM at baseline).
  • Assessment of the primary composite endpoint: cardiovascular death, myocardial infarction, ischemic stroke, or revascularization.

Main Results:

  • The primary endpoint occurred more frequently in patients with T2DM (HR 1.52) compared to those without.
  • Colchicine's cardiovascular benefit was consistent across patients with and without T2DM (HR 0.87 vs. 0.64, p-interaction=0.14).
  • New-onset T2DM incidence was numerically lower with colchicine (1.5%) versus placebo (2.2%), though not statistically significant (p=0.10).

Conclusions:

  • Colchicine demonstrates consistent cardiovascular benefits in patients with chronic CAD, irrespective of their diabetes mellitus status.
  • The potential role of colchicine in preventing new-onset diabetes requires further investigation through larger prospective trials.
  • Current findings are hypothesis-generating, underscoring the need for confirmatory studies.
Keywords:
colchicinecoronary artery diseasediabetes mellitusinflammationprevention

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