Colchicine and cardiovascular events: An updated meta-analysis of published randomized controlled trials.

BACKGROUND

Colchicine shows promise in reducing cardiovascular risk, but a recent study raised the question whether this is really the case. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess its impact on cardiovascular outcomes in secondary prevention.

METHODS

We systematically searched major databases up to March 2025 for RCTs comparing colchicine to placebo over a treatment duration of ≥12 months, reporting major adverse cardiovascular events (MACEs). Both fixed- and random-effects models were used to compute pooled risk ratios (RRs) and 95% confidence intervals.

RESULTS

Six RCTs comprising 21,774 patients were included. Colchicine significantly reduced the risk of MACEs (RR 0.74 [0.60-0.92]) and specific components of primary outcome (myocardial infarction, RR 0.85 [0.73-0.98]; stroke, RR 0.79 [0.65-0.95]), with no significant effect on cardiac death and revascularization.

CONCLUSION

These results support the efficacy of low-dose colchicine in reducing MACEs when added to standard care for at least 12 months.