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

Abstract

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