Efficacy and safety of colchicine for atrial fibrillation prevention: An updated meta-analysis of randomized controlled trials

Xu Tian; Nan Zhang; Panagiotis Korantzopoulos; George Bazoukis; Konstantinos P Letsas; Gary Tse; Tong Liu

doi:10.1016/j.ijcard.2024.132068

Efficacy and safety of colchicine for atrial fibrillation prevention: An updated meta-analysis of randomized controlled trials

Int J Cardiol. 2024 Jul 1:406:132068. doi: 10.1016/j.ijcard.2024.132068. Epub 2024 Apr 20.

Authors

Xu Tian¹, Nan Zhang¹, Panagiotis Korantzopoulos², George Bazoukis³, Konstantinos P Letsas⁴, Gary Tse⁵, Tong Liu⁶

Affiliations

¹ Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China.
² First Department of Cardiology, Faculty of Medicine, School of Health Sciences, University of Ioannina, Ioannina, Greece.
³ Department of Cardiology, Larnaca General Hospital, Larnaca, Cyprus; European University Cyprus, Medical School, Nicosia, Cyprus.
⁴ Arrhythmia Unit, Laboratory of Cardiac Pacing and Electrophysiology, Onassis Cardiac Surgery Center, Athens, Greece.
⁵ Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China; School of Nursing and Health Studies, Hong Kong Metropolitan University, Hong Kong, China. Electronic address: garytse86@gmail.com.
⁶ Tianjin Key Laboratory of Ionic-Molecular Function of Cardiovascular Disease, Department of Cardiology, Tianjin Institute of Cardiology, Second Hospital of Tianjin Medical University, Tianjin, China. Electronic address: liutongdoc@126.com.

PMID: 38648916
DOI: 10.1016/j.ijcard.2024.132068

Abstract

Background: Atrial fibrillation (AF), the most common arrhythmia, is closely related to inflammation. Colchicine has the potent anti-inflammatory effects. Several randomized clinical trials (RCTs) have evaluated the efficacy and safety of colchicine in the prevention of AF but the results are inconsistent.

Objective: The purpose of our study was to evaluate the impact of colchicine on AF.

Method and results: PubMed, EMBASE, Web of Science, Cochrane Library and ClinicalTrials.gov were searched for related studies until Jan 8, 2024. A total of 17 studies including 16,238 participants were included. Compared to the placebo group, there were fewer incidences of AF in the colchicine group (RR: 0.75, 95%CI: 0.68-0.83, P < 0.001). The incidence of overall adverse events and overall gastrointestinal intolerance did not differ significantly between the two groups. However, diarrhea, nausea, and discontinuation occurred more frequently in patients treated with colchicine.

Conclusion: Colchicine can prevent patients from the incidence of AF, regardless of the mean age of patients, type of atrial fibrillation, maintenance dose, duration of colchicine use, cumulative daily dose, and follow-up time with more diarrhea, nausea and discontinuation. These adverse events can be avoided by low doses (0.5 mg once daily) and long period time of colchicine use.

Keywords: Atrial fibrillation; Colchicine; Efficacy; Meta-analysis; Safety.

Publication types

Meta-Analysis
Research Support, Non-U.S. Gov't

MeSH terms

Atrial Fibrillation* / drug therapy
Atrial Fibrillation* / prevention & control
Colchicine* / adverse effects
Colchicine* / therapeutic use
Humans
Randomized Controlled Trials as Topic* / methods
Treatment Outcome

Substances

Colchicine