Does Colchicine Lower Gout Mortality Risk? Save

Data from a large UK database finds that gout patients starting urate-lowering therapy (ULT) will benefit from added colchicine prophylaxis by having fewer cardiovascular events. 

 

Prior studies have inconsistently suggested that colchicine may lower CV risk in Gout patients. Regarding Colchicine and CV risk, a systematic review of 4 observational studies (10,026 gout patients) found that colchicine significantly lowered the all-cause mortality risk (RR 0.58; 95% CI 0.43-0.79), but showed no difference if the risk of myocardial infarction (RR 0.71;  0.36-1.39), need for PCI, when comparing those on colchicine or not.

 

This retrospective study using data from the Clinical Practice Research Datalink Aurum, looked at those initiating ULT and compared people prescribed flare prophylaxis with colchicine with those not prescribed any gout flare prophylaxis. The primary outcome was a composite of fatal and non-fatal myocardial infarction or stroke within 180 days after urate-lowering therapy initiation regardless of any previous cardiovascular event was the primary outcome. 

 

At total of 99 800 gout patients initiating ULT were included (74% were male; 85% White with mean age 63 years). Colchicine prophylaxis was used in 16% of patients.  Cardiovascular event rates were: 

In addition to lowering gout flare rates, colchicine prophylaxis provides the additional benefit of a lower rate of cardiovascular events for up to the next 180 days compared with no prophylaxis. In the USA, colchicine is licenced for cardiovascular disease prevention.