General Rheumatology

Colchicine Linked to Decreased IL-6 and High-Sensitivity C-Reactive Protein Levels in Coronary Artery Disease

Rheumatology Advisor Contributing Writer
|
Inflammation plays an important role in MI among patients with RA, as supported by a study that documented elevated levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 in patients with RA. High levels of TNF-alpha and IL-6 were associated with the severity of subclinical atherosclerosis as measured by coronary artery calcification and were independent of Framingham risk score and diabetes mellitus. Ongoing and persistent disease activity may be necessary to maintain progression of atherosclerotic burden. A study found no detectable signs of atherosclerosis in patients with newly diagnosed RA as compared to controls when measuring endothelial-dependent flow-mediated dilation and intima media thickness despite elevated serum markers for endothelial activation.
Inflammation plays an important role in MI among patients with RA, as supported by a study that documented elevated levels of tumor necrosis factor (TNF)-alpha and interleukin (IL)-6 in patients with RA. High levels of TNF-alpha and IL-6 were associated with the severity of subclinical atherosclerosis as measured by coronary artery calcification and were independent of Framingham risk score and diabetes mellitus.

Ongoing and persistent disease activity may be necessary to maintain progression of atherosclerotic burden. A study found no detectable signs of atherosclerosis in patients with newly diagnosed RA as compared to controls when measuring endothelial-dependent flow-mediated dilation and intima media thickness despite elevated serum markers for endothelial activation.

Researchers evaluated the overall effect of colchicine treatment on interleukin-6 and C-reactive protein levels in patients with coronary artery disease.

The use of colchicine is associated with reduced interleukin-6 (IL-6) and high sensitivity C reactive protein (hs CRP) levels in patients with coronary artery disease (CAD), according to study results published in European Journal of Pharmacology.

This meta-analysis and systematic review included 11 clinical trials (9 studies on hs-CRP only; 2 studies on both hs-CRP and IL-6) published before October 2021 and were comprised of 749 patients with CAD treated with colchicine and 716 control participants with CAD. Data were collected from Embase, PubMed/MEDLINE, and the Cochrane Central Register of Controlled Trials. Weighted mean differences (WMDs) were used to compare hs-CRP and IL-6 level reduction between the colchicine and control groups.

Colchicine was significantly associated with reduced hs-CRP levels (WMD -0.81 mg/L; 95% CI, -1.34 to -0.28; I2=74%; P =.003) among those with CAD compared with control participants. In addition, IL-6 levels were significantly lower among colchicine users compared with placebo (WMD -1.28 pg/mL; 95% CI, -2.35 to -0.21; I2=11%; P =.02). Subgroup analysis showed colchicine to be associated with significantly reduced hs-CRP levels when used for more than 7 days (WMD -0.65 mg/L; 95% CI, -1.08 to -0.21; P =.004) and in studies with baseline hs-CRP levels of 3.0 mg/L or greater (WMD -0.99 mg/L; 95% CI, -1.92 to -0.06; P =.04).

Limitations of the study included the use of only 2 clinical trials that considered IL-6, the lack of evaluation on the safety of colchicine, high heterogeneity among included studies, and an inability to explain the relationship between decreased cardiovascular events and reduced inflammatory marker levels.

The study authors concluded, “[C]olchicine treatment was associated with a reduction in hs-CRP and IL-6 levels in patients with CAD.” However, they stated they “could not determine the individualized factors for treating patients with CAD based on available evidence,” which they indicated merits future research on “the effect of colchicine on inflammatory markers.”

Reference

Pan Z, Cheng J, Yang W, Chen L, Wang J. Effect of colchicine on inflammatory markers in patients with coronary artery disease: a meta-analysis of clinical trials. Eur J Pharmacol. Published online May 27, 2022. doi:10.1016/j.ejphar.2022.175068

  • Latest News Your top articles for Saturday

  • Haymarket Medical NetworkTop Picks

  • Loading...

    Continuing Medical Education (CME/CE) Courses

    Show More