17 September 2020

Colchicine, an anti-inflammatory drug that has been used for gout for centuries, has been shown to prevent cardiovascular disease in patients who have ever had a heart attack or are suffering from narrowed coronary arteries. A low dose of the drug reduces the risk of this by thirty percent. A study led by cardiologist and Professor Jan Hein Cornel of the Radboudumc has shown this. The results have now been published in the scientific journal New England Journal of Medicine.

Jan Hein Cornel: "We looked at the effect of Colchicine in over 5,500 patients who had a heart attack or suffered from narrowed coronary arteries in the past. Half of the patients received 0.5 mg of Colchicine every day, the rest received a placebo. The researchers found that there were fewer heart attacks in the group receiving Colchicine. These people also needed much less doctor's surgery. There was no difference in side effects between the groups, whose patients participated in the study for an average of 2.5 years. Professor Jan Hein Cornel, who specializes in inflammation of the vascular wall, is also affiliated with the Northwest Hospital Group in Alkmaar and the Working Group of Cardiologists in the Netherlands (WCN). He conducted the research together with cardiologists from the Netherlands and Australia.

Centuries-old medicine against gout

Colchicine is a natural anti-inflammatory that has been used for centuries to treat conditions such as gout. It is extracted from autumn tides, a crocus-like plant. Heart attacks are caused by arteriosclerosis, a prolonged process aggravated by chronic inflammation. The idea of investigating Colchicine as a possible remedy for cardiovascular disease arose when doctors saw that rheumatism patients who received the drug were less likely to have cardiovascular disease. Last year, research showed that a low dose of Colchicine prevents dotter treatments immediately after a heart attack. This study is the first to show that the drug can also prevent another cardiovascular disease in chronic heart patients.

Medicine not yet readily available for patients

Although cheap and easily available, Colchicine is not yet given to patients with chronic heart disease. This is only possible if it is registered for the treatment of patients who have (had) constricted coronary arteries or a heart attack. Jan Hein: "We have shown with this research that it really matters to patients. There is no need for hospitalization or doctor's treatment. You can imagine that this also leads to lower healthcare costs for this group of patients. More than 1.5 million people in the Netherlands live with chronic cardiovascular disease. Every year, approximately 34,000 people in the Netherlands end up in hospital with a heart attack.

More research into arteriosclerosis in the Radboudumc

In the coming years, Jan Hein will do more research into arteriosclerosis (atherosclerosis) within the theme of vascular damage. Arteries transport oxygen-rich blood from the heart to the organs and tissues. Everybody experiences calcification of these arteries. It is the process by which the wall of the arteries becomes thicker due to calcification or sores develop on them, which lead to inflammation. This can lead to constriction of blood vessels and problems with the circulation of organs and tissues. Cardiovascular diseases, such as heart attack, angina pectoris, stroke, TIA or peripheral vascular disease (shop window legs) can be caused. Jan Hein: "Our next research focuses on the question why Colchicine in particular works well in this group of patients. The Radboudumc does a lot of fundamental research into inflammation. This knowledge enables us to help patients better, because more than 40 percent of patients with an acute heart attack turn out to have an inflammation on a wall. To date, insufficient attention has been paid to this.

About the research

The low-dose colchicine for secondary prevention of cardiovascular disease (LoDoCo2) study was conducted by cardiologists from thirty Dutch and nine Australian hospitals. The coordination in the Netherlands was in the hands of the Vereniging Werkgroep Cardiologische centra Nederland (WCN) and was made possible by the Hartstichting and ZonMw. The results were presented at the (virtual) Congress of the European Society of Cardiology (ESC) in Amsterdam.

Publication in New England Journal of Medicine: Colchicine in Patients with Chronic Coronary Disease - Stefan M. Nidorf, Aernoud T.L. Fiolet, Eagle Mustard, John W. Eikelboom, Astrid Schut, Tjerk S.J. Opstal, Salem H.K. The, Xiao-Fang Xu, Mark A. Ireland, Timo Lenderink, Donald Latchem, Pieter Hoogslag, Anastazia Jerzewski, Peter Nierop, Alan Whelan, Randall Hendriks, Henk Swart, Jeroen Schaap, Aaf F. M. Kuijper, Maarten W.J. van Hessen, Pradyot Saklani, Isabel Tan, Angus G. Thompson, Allison Morton, Chris Judkins, Willem A. Bax, Maurits Dirksen, Marco M.W. Alings, Graeme J. Hankey, Charley A. Budgeon, Jan G.P. Tijssen, Jan H. Cornel and Peter L. Thompson.

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