P087 Cardioprotective effects of colchicine in people with gout: a systematic review

Prior, James A; Umar, Zainah; Ibrahim, Nooran; Bajpai, Ram; Partington, Richard; Mamas, Mamas; Roddy, Edward

Abstract

Background/Aims Colchicine is widely used in clinical practice to prevent and treat gout flares. Randomised controlled trials (RCT) have demonstrated cardiovascular benefits of colchicine in people with chronic coronary artery disease (CAD) or a recent myocardial infarction (MI). Whilst it is tempting to assume that these cardioprotective effects extend to people with gout, the duration of colchicine therapy is often much shorter in clinical practice and the prevalence of cardiovascular disease (CVD) lower than in these RCTs. The aim of this systematic review was to examine the effects of colchicine on cardiovascular outcomes in people with gout. Methods The medical literature databases MEDLINE, Embase, and Cochrane Central were searched from inception to June 2024, focusing on cohort studies and RCTs that compared cardiovascular disease outcomes between adults with gout using colchicine and those who do not. After each stage of review, conducted independently by at least two reviewers, included studies were narratively synthesised. Results From 5005 studies identified, six studies satisfied our inclusion criteria and were included. All six studies used a retrospective cohort design and across these, data ranged from 2006-2017. Three studies were from the USA, and one each from China, New Zealand and the UK. Only Soloman et al. found colchicine to have a cardioprotective effect on a composite CVD outcome (first MI, stroke or TIA, adjusted Hazard Ratio [aHR] 0.51 [95%CI 0.30-0.88]). Shah et al. only found colchicine to be protective in people with gout who had incident CAD if CKD was absent (HR 0.31[0.14-0.70]). Ju et al. and Ho et al. found no association between colchicine use in people with gout and subsequent ‘major adverse cardiovascular events’ (aHR 0.92 [0.75-1.12] and OR 1.14 [0.59-2.20] respectively). Finally, Cai et al. and Roddy et al. found an increased risk of ‘fatal or first non-fatal CVD event’ (men only; aHR 0.84 [0.77-0.92]), or ‘incident MI’ (aHR 1.55 [1.10-2.17]), respectively, in people with gout who used colchicine compared to those who did not. Conclusion The cardioprotective effects of colchicine in people with gout in a small number of large real-world cohort studies are varied. Variations in study design, clinical characteristics and drug dose/duration may explain these results, and further evidence is required before colchicine can be recommended to prevent CVD outcomes in people with gout. Disclosure J.A. Prior: None. Z. Umar: None. N. Ibrahim: None. R. Bajpai: None. R. Partington: None. M. Mamas: None. E. Roddy: None.

Citation

Prior, J. A., Umar, Z., Ibrahim, N., Bajpai, R., Partington, R., Mamas, M., & Roddy, E. (2025, April). P087 Cardioprotective effects of colchicine in people with gout: a systematic review. Poster presented at British Society for Rheumatology Annual Conference 2025, Manchester Central Convention Complex, Manchester, England UK

• Presentation Conference Type: Poster
• Conference Name: British Society for Rheumatology Annual Conference 2025
• Start Date: Apr 28, 2025
• End Date: Apr 30, 2025
• Acceptance Date: Apr 28, 2025
• Online Publication Date: Apr 28, 2025
• Publication Date: Apr 28, 2025
• Deposit Date: Jun 6, 2025
• Journal: Rheumatology
• Print ISSN: 1462-0324
• Electronic ISSN: 1462-0332
• Publisher: Oxford University Press
• Peer Reviewed: Peer Reviewed
• Volume: 64
• Issue: Supplement_3
• DOI: https://doi.org/10.1093/rheumatology/keaf142.127
• Public URL: https://keele-repository.worktribe.com/output/1242661
• Publisher URL: https://academic.oup.com/rheumatology/article/64/Supplement_3/keaf142.127/8115166