Colchicine prevents rise in total plaque volume for patients with stable CAD

 

 I bet we don't have enough brains in stroke to say; 'Maybe this would help in stroke also!'

 Really? You have disproved this research?

'No Hint of Benefit' in Large Colchicine Trial  November 2024

colchicine (23 posts to December 2011)

I bet your incompetent doctor and hospital DID NOTHING WITH THIS EARLIER RESEARCH! That's why they are incompetent! DOING NOTHING!

Colchicine prevents rise in total plaque volume for patients with stable CAD

Key takeaways:

• For patients with stable coronary artery disease, colchicine conferred lower total plaque volume as measured by coronary CT angiography vs. placebo.
• There was no effect on volume of low attenuation plaque.

CHICAGO — Among patients with stable coronary artery disease, colchicine lowered total plaque volume compared with placebo but had no impact on low attenuation plaque volume, researchers reported.

“If we can show both outcome data and mechanistic plaque data that are concordant, we should ... get more comfortable with these interventions, and I think colchicine is going to be one that will be used more in clinical practice based on the available clinical data,” Matthew J. Budoff, MD, investigator at The Lundquist Institute for Biomedical Innovation at Harbor-UCLA Medical Center, professor of medicine at the David Geffen School of Medicine at UCLA and program director and director of cardiac CT, division of cardiology, at Harbor-UCLA Medical Center, told Healio.

Data were derived from Budoff MJ, et al. Featured clinical research IV. Presented at: American College of Cardiology Scientific Session; March 29-31, 2025; Chicago (hybrid meeting).

For the EKSTROM trial, presented at the American College of Cardiology Scientific Session, Budoff and colleagues randomly assigned 84 patients with stable CAD to the anti-inflammatory drug colchicine 0.5 mg (Lodoco, Agepha Pharma) or placebo.

‘There is a lot of controversy’

Matthew J. Budoff

“There is a lot of controversy about colchicine use right now,” Budoff told Healio. “There have been a few positive trials and a negative trial more recently. There is a lot of unclear assessment of the clinical utility for colchicine today. Whether it improves atherosclerosis is critical in understanding its potential benefit for our patients.”

In the colchicine group, the mean age was 65.4 years and 94% were men. In the placebo group, the mean age was 63.8 years and 81% were men.

At 1 year, there was barely any change in either group in the primary outcome of low attenuation plaque (P = .344), but the key secondary outcome of total plaque volume was increased less in the colchicine group than in the placebo group (rise in percent atheroma volume, 0.3% vs. 1.4%; P = .015), Budoff said during a presentation.

“We are always interested in the vulnerable plaque, and we thought that given [colchicine’s] anti-inflammatory properties, it might affect low attenuation plaque, but we studied a stable coronary disease outpatient population,” Budoff told Healio. “The prevalence of low attenuation plaque was very low, so we couldn’t see a sizable benefit there. But percent atheroma volume, or total plaque, has been the primary outcome of every intravascular ultrasound study. And a 1% benefit translates into a 25% event reduction. So the fact that we saw a 1.1% benefit in plaque atheroma volume, we feel speaks toward the outcome data we already have from LoDoCo2 trial, which says that it reduces cardiac events by 30%. That’s very concordant with the outcome data.”

The difference was driven by changes in dense calcified plaque (rise in percent atheroma volume, 0.1% vs. 1%; P = .009), he said.

High-sensitivity C-reactive protein levels were lower in the colchicine group than in the placebo group at 1 year (0.35 mg/L vs. 0.65 mg/L), and the results were independent of baseline CRP, according to the researchers.

‘A very consistent answer’

Budoff said the researchers would like to perform a larger trial with more power to analyze individual plaque components. “It would also be interesting to do an acute coronary syndrome study, a population of patients who had high levels of inflammation, to see if there was more of an effect on low attenuation plaque that we were able to show in a stable coronary population,” he said.

Budoff said he has been giving colchicine to patients with stable CAD since the positive LoDoCo2 and COLCOT trials were published. “The EKSTROM trial further reinforces the benefits in this population,” he said. “While we still have some questions about acute myocardial infarction from other trials like CLEAR SYNERGY, I think we have a very consistent answer in patients with stable coronary disease that there’s benefit by being on low-dose colchicine.”

For more information:

Matthew J. Budoff, MD, can be reached at mbudoff@lundquist.org or on X @BudoffMd.