The Role of Colchicine in Atherosclerotic Cardiovascular Disease

Rahul Kurup; Keyvan Karimi Galougahi; Gemma Figtree; Ashish Misra; Sanjay Patel

doi:10.1016/j.hlc.2020.11.010

The Role of Colchicine in Atherosclerotic Cardiovascular Disease

Heart Lung Circ. 2021 Jun;30(6):795-806. doi: 10.1016/j.hlc.2020.11.010. Epub 2021 Jan 16.

Authors

Rahul Kurup¹, Keyvan Karimi Galougahi², Gemma Figtree³, Ashish Misra⁴, Sanjay Patel⁵

Affiliations

¹ The Heart Research Institute, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. Electronic address: https://twitter.com/drrahulkurup.
² The Heart Research Institute, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
³ Sydney Medical School, The University of Sydney, Sydney, NSW, Australia; Department of Cardiology, Royal North Shore Hospital, Sydney, NSW, Australia.
⁴ The Heart Research Institute, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia.
⁵ The Heart Research Institute, Sydney, NSW, Australia; Department of Cardiology, Royal Prince Alfred Hospital, Sydney, NSW, Australia; Sydney Medical School, The University of Sydney, Sydney, NSW, Australia. Electronic address: Sanjay.patel@hri.org.au.

PMID: 33461916
DOI: 10.1016/j.hlc.2020.11.010

Abstract

Colchicine, an inexpensive immunomodulatory drug used traditionally to treat gout and familial Mediterranean fever, is rapidly accumulating basic and clinical evidence for a therapeutic role in atherosclerotic cardiovascular disease. Its athero-protective properties are thought to be mainly related to its effect on tubulin polymerisation, enabling a broad range of effect on multiple atherosclerotic plaque cell types and cellular processes, including cell division, cell migration as well as pro-inflammatory cytokine and chemokine secretion. These properties indicate the potential to favourably affect all stages of atherosclerotic plaque development including formation, progression, destabilisation, and plaque rupture. This review focusses on the pharmacology of colchicine, the mechanisms by which it modulates atherosclerosis pathobiology, and summarises the current clinical evidence for its use along with the upcoming clinical trial landscape. Given the current lack of primary immunomodulatory drugs in the treatment of atherosclerosis, colchicine is a promising candidate to fill this therapeutic gap.

Keywords: Acute coronary syndrome; Atherosclerosis; Colchicine; Coronary artery disease; Inflammation; Myocardial infarction.

Publication types

Review

MeSH terms

Anti-Inflammatory Agents / therapeutic use
Atherosclerosis* / drug therapy
Cardiovascular Diseases*
Colchicine / therapeutic use
Coronary Artery Disease* / drug therapy
Humans
Plaque, Atherosclerotic* / drug therapy

Substances

Anti-Inflammatory Agents
Colchicine