A H Katsanos1,2, L Palaiodimou2, C Price3, S Giannopoulos4, R Lemmens5,6,7, M Kosmidou8, M K Georgakis9, C Weimar10, P J Kelly11, G Tsivgoulis2,12. 1. Division of Neurology, McMaster University/Population Health Research Institute, Hamilton, ON, Canada. 2. Second Department of Neurology, School of Medicine, 'Attikon University Hospital', National and Kapodistrian University of Athens, Athens, Greece. 3. Population Health Sciences Institute, Newcastle University, Newcastle upon Tyne, UK. 4. Department of Neurology, University of Ioannina School of Medicine, Ioannina, Greece. 5. Department of Neurosciences, Experimental Neurology and Leuven Research Institute for Neuroscience and Disease (LIND), KU Leuven - University of Leuven, Leuven, Belgium. 6. Center for Brain and Disease Research, Laboratory of Neurobiology, VIB, Leuven, Belgium. 7. Department of Neurology, University Hospitals Leuven, Leuven, Belgium. 8. First Department of Internal Medicine, University of Ioannina School of Medicine, Ioannina, Greece. 9. Institute for Stroke and Dementia Research, University Hospital, Ludwig-Maximilians-University (LMU), Munich, Germany. 10. Department of Neurology, University of Duisburg-Essen, Essen, Germany. 11. Health Research Board Stroke Clinical Trials Network Ireland and Mater University Hospital/University College Dublin, Dublin, Ireland. 12. Department of Neurology, University of Tennessee Health Science Center, Memphis, TN, USA.
Abstract
BACKGROUND AND PURPOSE: Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. METHODS: A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). RESULTS: Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months. CONCLUSION: Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
BACKGROUND AND PURPOSE: Although clinical trials suggest that colchicine may reduce the risk of vascular events in patients with a history of coronary artery disease, its effect on the prevention of cerebrovascular events still remains unclear. METHODS: A systematic review and meta-analysis was performed of all available randomized controlled trials (RCTs) reporting on incident strokes during the follow-up of patients with a history of cardiovascular disease randomized to colchicine treatment or control (placebo or usual care). RESULTS: Four RCTs were identified, including a total of 5553 patients (mean age 61 years, 81% males), with a follow-up ranging from 1 to 36 months. Colchicine treatment was associated with a significantly lower risk of incident stroke during follow-up compared to control (risk ratio 0.31, 95% confidence interval 0.13-0.71), without heterogeneity across included studies (I2 = 0%). Based on the pooled incident stroke rate of control groups (0.9%) in the included RCTs, it was estimated that administration of low-dose colchicine to 161 patients with coronary artery disease would prevent one stroke during a follow-up of 23 months. CONCLUSION:Colchicine treatment decreases stroke risk in patients with a history of coronary artery disease. The effect of colchicine in secondary stroke prevention is currently being evaluated in an ongoing RCT.
Authors: Claire X Y Goh; Ying Kiat Tan; Choon Han Tan; Aloysius S T Leow; Jamie S Y Ho; Natalie H W Tan; Sherill Goh; Andrew F W Ho; Vijay K Sharma; Bernard P L Chan; Leonard L L Yeo; Benjamin Y Q Tan Journal: J Thromb Thrombolysis Date: 2022-05-10 Impact factor: 2.300
Authors: Andreas Papadopoulos; Konstantinos Palaiopanos; Harry Björkbacka; Annette Peters; James A de Lemos; Sudha Seshadri; Martin Dichgans; Marios K Georgakis Journal: Neurology Date: 2021-12-30 Impact factor: 9.910
Authors: Peter Kelly; Christian Weimar; Robin Lemmens; Sean Murphy; Francisco Purroy; Anita Arsovska; Natan M Bornstein; Anna Czlonkowska; Urs Fischer; Ana Catarina Fonseca; John Forbes; Michael D Hill; Dalius Jatuzis; Janika Kõrv; Christina Kruuse; Robert Mikulik; Paul J Nederkoorn; Martin O'Donnell; Peter Sandercock; David Tanne; Georgios Tsivgoulis; Cathal Walsh; David Williams; Marialuisa Zedde; Christopher I Price Journal: Eur Stroke J Date: 2021-06-18