Low-dose colchicine may help prevent CV events in patients with type 2 diabetes and MI: COLCOT trial

The findings, published in Diabetes Care, offer further insight into the risks associated with and benefits of low-dose colchicine as a part of comprehensive secondary prevention approaches in patients with type 2 diabetes and a recent MI.

"In the prespecified analysis of the COLCOT trial, colchicine (0.5 mg daily) was linked with a 35% reduced risk of the primary composite endpoint of resuscitated cardiac arrest, cardiovascular death, stroke, myocardial infarction, and urgent hospitalization for angina needing revascularization in patients with type 2 diabetes and a recent MI," the researchers reported.

"Although the incidences of pneumonia and nausea were low, they were significantly greater in the colchicine arm than in the placebo arm."

In patients with coronary disease, the cardiovascular benefits of low-dose colchicine have been demonstrated. Jean-Claude Tardif, Montreal Heart Institute, Université de Montréal, Montreal, Quebec, Canada, and colleagues evaluated its effects in patients with type 2 diabetes from the COLchicine Cardiovascular Outcomes Trial (COLCOT).

COLCOT was a double-blinded, randomized trial of colchicine, 0.5 mg daily, versus placebo initiated within 30 days after a myocardial infarction. 959 patients with T2D were enrolled and monitored for a median of 22.6 months.

Based on the study, the following inferences were made:

• A primary endpoint event occurred in 8.7% of patients in the colchicine group and 13.1% in the placebo group (hazard ratio 0.65).
• Nausea was reported in 2.7% and 0.8% of the study groups, and pneumonia occurred in 2.4% and 0.4%.

"Among patients with type 2 diabetes and a recent myocardial infarction, colchicine, 0.5 mg daily, leads to a large reduction of cardiovascular events," the researchers wrote.

"These results support the conduct of the COLCOT-T2D trial in primary prevention," they concluded.

Reference:

François Roubille, Nadia Bouabdallaoui, Simon Kouz, David D. Waters, Rafael Diaz, Aldo P. Maggioni, Fausto J. Pinto, Jean C. Grégoire, Habib Gamra, Ghassan S. Kiwan, Colin Berry, José López-Sendón, Wolfgang Koenig, Laurent Delorme, Meyer Elbaz, Pierre Coste, Mylène Provencher, Zohar Bassevitch, Lucie Blondeau, Philippe L. L’Allier, Marie-Claude Guertin, Jean-Claude Tardif; Low-Dose Colchicine in Patients With Type 2 Diabetes and Recent Myocardial Infarction in the COLchicine Cardiovascular Outcomes Trial (COLCOT). Diabetes Care 2024; dc231825. https://doi.org/10.2337/dc23-1825