A new Cochrane review suggests that low-dose colchicine, a widely used and inexpensive gout medication, could reduce the risk of heart attacks and strokes in people with cardiovascular disease. The analysis of 12 trials involving nearly 23,000 patients showed significant benefits with minimal side effects. Researchers highlight its potential as an accessible prevention tool.
Colchicine, a standard treatment for gout, has shown promise in lowering the risk of cardiovascular events due to its anti-inflammatory properties. Cardiovascular disease often involves chronic low-level inflammation that heightens the chance of recurrent heart attacks and strokes, making colchicine a candidate for secondary prevention.
The Cochrane review examined 12 randomized controlled trials with almost 23,000 participants who had a history of heart disease, heart attack, or stroke. These individuals, mostly male (about 80%) with ages ranging from 57 to 74, took low doses of colchicine—typically 0.5 mg once or twice daily—for at least six months. Half received the drug alongside standard care, while the others got a placebo or no additional treatment.
Results indicated fewer cardiovascular events among those on colchicine. For every 1,000 people treated, the drug prevented 9 heart attacks and 8 strokes compared to controls. No serious adverse events occurred, though mild, short-lived gastrointestinal discomfort was more frequent in the colchicine group.
"Among 200 people with cardiovascular disease—where we would normally expect around seven heart attacks and four strokes—using low-dose colchicine could prevent about two of each," says Dr. Ramin Ebrahimi, co-lead author from University Medicine Greifswald, Germany. This could meaningfully impact patients facing lifelong cardiovascular risks.
"These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use," notes Lars Hemkens, senior author from the University of Bern, Switzerland. As the leading global cause of death, cardiovascular disease could benefit from such affordable strategies.
However, the review leaves questions unanswered, including effects on overall mortality, need for procedures like coronary revascularization, quality of life, or hospital stays. Further research is needed to fill these gaps.
The findings appear in the Cochrane Database of Systematic Reviews (2025; 11), DOI: 10.1002/14651858.CD014808.pub2.