Effects of colchicine in adults with metabolic syndrome: A pilot randomized controlled trial

Abstract

Aim To evaluate the efficacy and safety of colchicine for improving metabolic and inflammatory outcomes in people with obesity and metabolic syndrome (MetS). Materials and methods Adults with obesity and MetS, but who did not have diabetes, were randomized to colchicine 0.6 mg or placebo capsules twice daily for 3 months. The primary outcome was change in insulin sensitivity (SI) as estimated by insulin‐modified frequently sampled intravenous glucose tolerance tests. Secondary outcomes included changes in other metabolic variables and inflammatory markers. Results Of 40 participants randomized (21 colchicine, 19 placebo), 37 completed the trial. Compared with placebo, colchicine significantly reduced C‐reactive protein (P <0.005), erythrocyte sedimentation rate (P <0.01), white blood cell count (P <0.005), and absolute neutrophil count (P <0.001). Change in SI was not significantly different between colchicine and placebo arms (difference: +0.21 × 10−5; CI −1.70 to +2.13 × 10−5 min−1 mU−1 mL; P = 0.82). However, changes in some secondary outcomes, including homeostatic model assessment of insulin resistance (P = 0.0499), fasting insulin (P = 0.07) and glucose effectiveness (P = 0.08), suggested metabolic improvements in the colchicine versus placebo group. Adverse events were generally mild and similar in both groups. Conclusions This pilot study found colchicine significantly improved obesity‐associated inflammatory variables and showed a good safety profile among adults with obesity and MetS who did not have diabetes. These results suggest a larger, adequately powered study should be conducted to determine whether colchicine improves insulin resistance and other measures of metabolic health in at‐risk individuals.

Anti-inflammatory therapy for COVID-19 infection: the case for colchicine

“…45 Finally, colchicine has also been shown to dampen the inflammatory response and reduce CRP levels among subjects with metabolic syndrome. 68 These data support the general anti-inflammatory effect of colchicine, independent of a specific disease state.…”

Short-term effect of low-dose colchicine on inflammatory biomarkers, lipids, blood count and renal function in chronic coronary artery disease and elevated high-sensitivity C-reactive protein

“…Although absolute reduction of hs-CRP and IL-6 were larger in these studies in which baseline levels were higher, the relative reduction was similar. The reduction in the current study was achieved with a lower dose of colchicine [21,22]. Systemic hs-CRP and IL-6 reduction have not been observed when administrating colchicine directly after acute myocardial infarction [14,23,24].…”

Adverse events during oral colchicine use: a systematic review and meta-analysis of randomised controlled trials

“…Pooled data from these studies showed 0.6% (95% CI 0.3, 0.9) of participants using colchicine reported a haematology event compared to 0.4% (95% CI 0.2, 0.7) of participants in placebo groups. The occurrence of haematology events in colchicine or comparator groups was reported by three studies [21,23,37]. The meta-analysis showed an overall non-significant RR (95% CI) of haematology events in 1.34 (0.64, 2.82) (Supplementary Figure 6, Table 2).…”

“…Characteristics of participants in the included studies are shown in Table 1. A number of disease states were studied including cirrhosis (n = 5 studies) [6][7][8][9][10], pericarditis (n = 4 studies) [26,27,29,31], gout (n = 5 studies) [15,18,34,38,39], knee osteoarthritis (n = 3 studies) [16,20,30], Behcet's syndrome (n = 3 studies) [21,32,40], psoriatic arthritis (n = 2 studies) [13,36], post-pericardiotomy syndrome (n = 2 studies) [25,28], chronic obstructive pulmonary disorder (n = 1 study) [19], bare-metal stent restenosis (n = 1 study) [22], metabolic syndrome (n = 1 study) [23], lung resection surgery (n = 1 study) [17], myocardial infarction (n = 1 study) [37], familial Mediterranean fever (n = 1 study) [12], asthma (n = 1 study) [24], primary sclerosing cholangitis (n = 1 study) [11], aphthous stomatitis (n = 1 study) [33], allergic rhinitis (n = 1 study) [14] and low back pain (n = 1 study) [35]. Sample sizes ranged from 11 to 4745, with a pooled sample of 8659 adult participants.…”