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Colchicine Shows Potential in Reducing Recurrent Strokes, Study Finds

A recent study published in Lancet reveals that the medication colchicine, which has anti-inflammatory characteristics, may help avoid repeated strokes.  Colchicine previously demonstrated potential in mitigating heart disease stemming from clogged arteries.

 Strokes, unlike heart disease, can have a variety of causes, including problems with small blood vessels and unknown variables.  Researchers wanted to explore if long-term colchicine use could reduce the risk of future stroke in individuals who had previously had a mild stroke or a high-risk transient ischemic attack (TIA), which is a brief period of stroke-like symptoms.

 The study included 3,154 hospital patients divided into two groups: one received colchicine in addition to their normal therapy, while the other received only their usual care.

 The primary purpose was to see if colchicine could prevent catastrophic occurrences such as further strokes, heart attacks, cardiac arrest, or hospitalisation for chest pain (unstable angina).

 The trial lasted from December 2016 until January 2024 and despite the project ending earlier than expected due to COVID-19 budget concerns, we gathered important data.

According to the study, 9.8% of patients on colchicine encountered significant events, compared to 11.7% of patients receiving standard therapy, While the difference was not statistically significant (p = 0.12), it does point towards a possible benefit of colchicine.

 Furthermore, patients using colchicine had decreased levels of C-reactive protein (CRP), an inflammatory marker, at multiple checkpoints throughout the research.

Prof.  Eric Topol commented on the subject, stating that in June 2023, the FDA approved colchicine (LoDoCo) to prevent cardiovascular events, making it the first anti-inflammatory medicine licensed for this purpose.

 In a recent blog post, he stated that the findings are consistent with the previous five studies, demonstrating statistical significance.

 In 2017, the CANTOS study looked at a monoclonal antibody to interleukin-1β in more than 10,000 people with a heart attack and hs-CRP levels of 2 mg/l or higher.

 This added to the body's knowledge about how to fight inflammation beyond colchicine.

 The three doses together resulted in a 15% reduction in the primary endpoint of heart attack, stroke, or cardiac death.

 In the two high-dose groups, the absolute incidence rates dropped from 4.5 to 3.9.

 Professor Topol highlighted the importance of lipid-lowering in treating arterial inflammation by achieving the reduction in the primary endpoint with no change in lipids.

However, he claims that the experiment revealed a higher rate of fatal infection, with 0.18% in the control group and 0.30% in the two higher dose groups, and as a result, Novartis, who was developing the medicine, decided not to pursue it for the cardiovascular indication.

The study found no obvious statistical benefit of colchicine in preventing recurrent strokes.  However, the findings indicate that future studies should further investigate the potential benefits of anti-inflammatory therapies like colchicine.

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