Efficacy of colchicine on major limb and cardiovascular adverse events in peripheral artery disease: a pilot meta-analysis

Peripheral artery disease (PAD) significantly increases the risk of severe cardiovascular and limb complications, often due to underlying inflammation from atherosclerosis. This chronic inflammatory state suggests that anti-inflammatory therapies might help reduce these risks. Colchicine has gained attention due to its efficacy for primary and secondary prevention of cardiovascular events, and may offer similar protective benefits for PAD. However, the current literature on the efficacy of colchicine on cardiovascular and limb outcomes in PAD patients is limited.

The purpose of this meta-analysis is to investigate the effectiveness of colchicine in reducing the risk of adverse cardiovascular and limb events in patients with PAD.

A systematic literature search was performed on the major bibliographic databases (Medline, Embase, Web of Science, and the Cochrane Library) for studies until October 2024. Hazard ratios (HR) with their corresponding 95% confidence intervals were pooled using the inverse-variance random-effects model, and a p-value of <0.05 was considered statistically significant.

3 studies were included with a total of 226,804 patients [113,537: colchicine and 113,267: control]. The colchicine group included 60.1% males with a mean age of 73.3 ± 10.8 years, while the control group included 60.6% males with a mean age of 73.5 ± 10.83 years. The pooled analysis demonstrates colchicine use in patients with PAD was associated with a significantly lower risk of major adverse limb events (MALE) [HR: 0.84; 95% CI: 0.75, 0.94; p=0.002], major adverse cardiovascular events (MACE) [HR: 0.90; 95% CI: 0.82, 0.98; p=0.02], ischemic stroke [HR: 0.97; 95% CI: 0.94, 0.99; p=0.02], myocardial infarction (MI) [HR: 0.81; 95% CI: 0.75, 0.87; p<0.00001], need for major amputations [HR: 0.81; 95% CI: 0.75, 0.87; p<0.00001] and revascularization for lower limb ischemia [HR: 0.81; 95% CI: 0.72, 0.90; p=0.0001]. However, no significant reduction was noted for all-cause mortality [HR: 0.87; 95% CI: 0.74, 1.02; p=0.09].