Core Concepts
Low-dose colchicine is a new approach to treating atherosclerotic cardiovascular disease by targeting inflammation.
Abstract
The recent US approval of low-dose colchicine 0.5 mg for atherosclerotic cardiovascular disease (ASCVD) signifies a novel treatment strategy focusing on inflammation. The drug's broad label allows its use in adult patients with established ASCVD or multiple cardiovascular risk factors. Key insights include:
Approval of colchicine opens discussions on residual inflammatory risk in patients.
The drug offers a new option for treating residual risk beyond standard care like statins.
Different experts have varying opinions on the necessity of measuring hsCRP for patient selection.
Colchicine is seen as a potential second pillar of ASCVD treatment alongside statins.
Concerns about polypharmacy and patient selection for colchicine use are raised.
Safety and tolerability of the 0.5-mg colchicine dose are considered manageable.
Colchicine may become a fundamental part of cardiovascular treatment in the future.
Stats
The LoDoCo-2 trial supported colchicine's use in ASCVD with a broad population.
Around 30%-40% of ASCVD patients on statins may benefit from colchicine.
Colchicine is not recommended for patients with severe kidney disease.
Quotes
"This FDA approval is extremely important, as it will draw attention to the role of inflammation in atherosclerosis and the need to treat it." - Paul Ridker