Colchicine Is a Weapon for Managing the Heart Disease Among Interstitial Lung Disease With Viral Infection: Have We Found the Holy Grail?

Abstract

BackgroundThis study investigated the effect of colchicine use on the risks of heart disease (HD), pericarditis, endocarditis, myocarditis, cardiomyopathy, cardiac arrhythmia, and cardiac failure in patients having interstitial lung disease (ILD) with virus infection (ILD cohort).MethodsWe retrospectively enrolled ILD cohort between 2000 and 2013 from the Longitudinal Health Insurance Database and divided them into colchicine users (n = 12,253) and colchicine non-users (n = 12,253) through propensity score matching. The event of interest was the diagnosis of HD. The incidence of HD was analyzed using multivariate Cox proportional hazards models between colchicine users and the comparison cohort after adjustment for age, sex, medication, comorbidities, and index date based on the time-dependent analysis.ResultsColchicine users had a significantly lower risk of HD (aHR = 0.87, 95% confidence interval (CI]) = 0.82–0.92) than did the colchicine non-user. For colchicine non-users as the reference, the aHR (95% CI) of the patients who received colchicine of 2–7, 8–30, 31–150, and > 150 days were 0.89 (0.81–0.98), 0.84 (0.76–0.94), 090 (0.80–0.99), and 0.83 (0.74–0.93), respectively; regardless of duration use, the lower risk of HD persisted in colchicine users. The cumulative incidence of HD in colchicine users was significantly lower than that in the colchicine non-users (log-rank p < 0.001).ConclusionThe addition of short-term or long-term colchicine to standard medical therapy may have benefits to prevent the HD among the ILD patients concurrent with a virus infection or comorbidities even in elderly patients.

Efficacy and safety of colchicine for the treatment of myopericarditis

“…Interference with microtubules leads to inhibition of a large number of cellular functions, including neutrophil activation, endothelial cell adhesion, migration to injured tissues and cytokine production, resulting in a sustained anti-inflammatory effect. 15 16 Furthermore, even in animal models of viral myocarditis, colchicine has been shown to reduce inflammatory and myocardial lesion markers, as well as the apoptosis of cardiomyocytes. In particular, it appears to reduce NLRP3 inflammasome activity, which is associated with reduced release of IL-1, as well as reduced infiltration of immune cells into the myocardium.…”

“…13 Colchicine is a non-selective inhibitor of the inflammasome and thus reduces the generation of proinflammatory cytokines, especially interleukin-1. [13][14][15][16] Colchicine is able to prevent microtubule assembly in immune system cells, particularly in neutrophils, where its peak concentration can be more than 16 times higher than the peak concentration in plasma. Interference with microtubules leads to inhibition of a large number of cellular functions, including neutrophil activation, endothelial cell adhesion, migration to injured tissues and cytokine production, resulting in a sustained antiinflammatory effect.…”

Assistance of metagenomics next-generation sequencing for diagnosis of adenovirus pericarditis with pericardial effusion in a child: a case report and literature review

“…Glucocorticoids are second-line therapy for patients who are unresponsive or intolerant to NSAIDs and colchicine. ( 21 ). Considering that the patient's pericardial effusion is not related to systemic inflammatory diseases, we did not choose aspirin, NSAIDs, or colchicine for treatment.…”

Coronavirus disease 2019 (COVID-19) pandemic and autoimmune rheumatic diseases: Outcomes and prospects

“…В отношении фармакотерапии COVID-19 основные наде жды возлагались в первую очередь на противовирусные эффекты высоких доз этих препаратов [238,264], в то время как в ревматологии применение ГХ (в низких дозах) основывалось на их антивоспалительных, иммуномодулирующих и антикоагулянтных эффектах [237]. На экспериментальной модели АФС получены данные об «антикоагулянтном» действии ГХ [265,266] и нормализации антикоагулятных свойств ЭК [267,268]. В клинических исследованиях продемонстрированы «антитромботические» эффекты ГХ и снижение концентрации аФЛ у пациентов с первичным АФС [242][243][244][245][246][247].…”

“…Колхицин является одним из наиболее эффективных препаратов для лечения идиопатического рецидивирующего перикардита [266]. Имеются данные о снижении частоты кардиоваскулярной патологии (осложнения атеросклероза, перикардит, эндокардит, миокардит, кардиомиопатия, сердечная аритмия, сердечная недостаточность) на фоне лечения колхицином у пациентов с ИЗЛ [267].…”