A low-cost gout drug long used for gout may help protect the heart and prevent repeat strokes, according to a new Cochrane review. Researchers found that small daily doses of colchicine reduced the number of heart attacks and strokes in people with cardiovascular disease.
Cardiovascular disease remains the world’s leading cause of death, often fueled by chronic inflammation that damages blood vessels and triggers new heart events. Because colchicine works by calming inflammation, scientists are exploring whether it can also help the heart.
The review analyzed 12 randomized controlled trials involving nearly 23,000 adults who had already had heart disease, a previous heart attack or stroke. Participants received either 0.5 mg of colchicine once or twice a day or a placebo for at least six months, in addition to their regular medications such as statins or blood thinners.
Overall, the results were consistent: Those taking colchicine were less likely to experience a heart attack or stroke. The data showed that for every 1,000 patients treated, there were nine fewer heart attacks and eight fewer strokes than those who did not take the drug. Side effects, when they occurred, were mostly mild digestive symptoms such as stomach upset and usually went away on their own.
Dr. Ramin Ebrahimi, co-director of the University Medicine Greifswald in Germany, explained that even a small reduction is important. “Out of 200 people with heart disease—where we would normally expect seven heart attacks and four strokes,” he said. “That makes a real difference for patients who are at lifelong heart risk.”
The researchers say these findings are particularly encouraging because colchicine is cheap and widely available. Unlike many new heart medications that cost hundreds of dollars per month, colchicine has been prescribed for gout and other inflammatory conditions for decades. Reinventing such drugs could make treatment accessible to patients worldwide, including those in low-resource settings.
“This is a great example of how academic research can uncover new benefits from old drugs,” said senior author Dr. Lars Hamkins of the University of Bern in Switzerland. “This is a publicly funded search for a very old, low-cost drug for an entirely new use.”
Still, reviews of gout drugs yielded no answers. Researchers could not confirm whether colchicine affected overall survival or reduced the need for heart procedures such as stent placement or bypass surgery. There was also limited evidence on whether it improved quality of life or shortened hospital stays. Future studies are expected to explore these gaps and determine optimal dosing schedules for long-term use.
Colchicine’s heart benefits are thought to come from its ability to reduce inflammation in artery walls, where plaque buildup can cause dangerous blockages. By controlling this inflammation, drugs can help stabilize the plaque and prevent it from rupturing.
Review authors caution that colchicine is not for everyone. It should only be taken under medical supervision, especially since it may interact with other medications or cause digestive discomfort in some patients. People with kidney or liver disease may need dose adjustments or alternative treatments.
As researchers continue to examine colchicine’s role in heart health, many cardiologists see it as an emerging tool for secondary prevention. For millions of patients with chronic heart disease, this decades-old gout drug could become a new layer of protection at a fraction of the usual price.
Sources:
Common gout drugs show promise in preventing heart attacks and strokes
Colchicine for secondary prevention of cardiovascular events
