The potential role of Colchicine in preventing coronary vascular disease in childhood-onset lupus: a new view on an old drug

Pediatr Rheumatol Online J. 2021 Feb 16;19(1):15. doi: 10.1186/s12969-021-00504-6.

Abstract

Background: Patients with systemic lupus erythematous have a significantly increased risk of cardiovascular disease, which is not fully explained by traditional cardiovascular disease risk factors. Despite increasing life expectancy in patients with systemic lupus erythematous, mortality due to cardiovascular disease, the major cause of death in these patients, has not changed. Children with lupus suffer from more aggressive disease compared to their adult counterparts, and there is a growing concern for their increased risk of cardiovascular disease as they age. BODY: There is an unmet need for therapies to address the increased risk of cardiovascular disease in childhood-onset lupus. Colchicine has many anti-inflammatory and cardiovascular protective properties, including inhibition of IL-1β and IL-18 activity, key proinflammatory cytokines that are predictive of future adverse cardiovascular events. In the Colchicine Cardiovascular Outcomes Trial (COLCOT), colchicine was recently found to have significant benefit with minimal risk in adults with previous myocardial infarction for prevention of secondary vascular disease. While adult studies are promising, no studies have been conducted in pediatric patients to investigate colchicine's potential for cardiovascular protection in children and adolescents with lupus.

Conclusions: Studies investigating colchicine's potential role for cardiovascular protection are needed in pediatric patients with systemic lupus erythematous.

Keywords: Atherosclerosis; Cardiovascular Disease; Colchicine; Prevention; Systemic lupus erythematous.

Publication types

  • Review

MeSH terms

  • Age of Onset
  • Child
  • Colchicine / pharmacology*
  • Coronary Artery Disease* / etiology
  • Coronary Artery Disease* / prevention & control
  • Heart Disease Risk Factors
  • Humans
  • Lupus Erythematosus, Systemic* / complications
  • Lupus Erythematosus, Systemic* / drug therapy
  • Lupus Erythematosus, Systemic* / epidemiology
  • Protective Agents / pharmacology

Substances

  • Protective Agents
  • Colchicine