Is Colchicine Effective for Preventing Ischemic Stroke? A Real-World Analysis
Henrique Cian da Cruz1, Mariana Letícia de Bastos Maximiano2, Savio Batista3, Julia Tirelli Rocha4, Matheus Pereira5
1Faculty of Medicine, Cesumar University, 2Faculty of Medicine, Fluminense Federal University, 3Emory University, 4Faculty of Medicine, Jundiaí Medical School, 5Faculty of Medicine, University of Valença
Objective:
This study aims to analyze the effects of colchicine for secondary prevention of ischemic stroke and major adverse cardiovascular events (MACE) through data from a Global Federated Health Network.
Background:
Colchicine has been used for conditions like gout and familial Mediterranean fever. Its anti-inflammatory properties have made it a valuable therapeutic option in the management of autoimmune and inflammatory diseases. Recent studies suggest its potential benefits in cardiovascular conditions, including stable ischemic heart disease. However, its role in the secondary prevention of ischemic stroke and major cardiovascular events remains uncertain.
Design/Methods:
This observational study analyzed anonymized electronic medical records obtained from a global health research network, with a primary focus on healthcare organizations in the United States. The study evaluated the effects of colchicine on secondary prevention of ischemic stroke (ICD-10 I63) over a minimum treatment period of three months. Propensity score matching (PSM) was employed to balance baseline characteristics and reduce confounding factors, ensuring comparability between patients who received colchicine and those who did not. The analysis controlled for key variables, including diabetes mellitus, hypertensive diseases, overweight and obesity, and disorders of lipoprotein metabolism and other lipidemias.
Results:
218,171 patients were identified, with 15,176 patients in each branch after PSM. The monitoring period lasted approximately 2.5 years, with a standard deviation of about 2.8 years. Contrary to recent studies, the risk ratio of secondary events was higher in the colchicine group compared to the control group (RR 1.082, 95% CI 1.051 - 1.114). There was no significant difference in the mortality rate between the groups (HR 0.976, 95% CI 0.937 - 1.015).
Conclusions:
In this real-world study, colchicine showed a reduced risk of secondary events in patients with a history of stroke or coronary artery disease. These findings emphasize the necessity for additional clinical trials to verify these outcomes and examine the underlying mechanisms involved.
Disclaimer: Abstracts were not reviewed by Neurology® and do not reflect the views of Neurology® editors or staff.