High sensitivity C-Reactive Protein (hs-CRP) has been clearly identified as a marker of cardiovascular risk. While evidence suggests that pharmacologic therapies such as Hmg CoA Reductase inhibitors, or statins, lower hs-CRP in conjunction with improved Low Density Lipoprotein (LDL), it is not known if lowering hs-CRP independent of other cardiovascular risk factors will lead to improved cardiovascular outcomes. The Low Dose Colchicine – Vascular Reactivity and Inflammatory Cascade (LoDoCo VRIC) study is a randomised single blinded crossover design trial administering the anti-inflammatory colchicine orally (1mg/day) or standard treatment for three months to 48 patients with stable coronary artery disease. While a trend to lowered hs-CRP and Serum Amyloid A (SAA) was seen there was no effect on other measures of cardiovascular risk, most notably LDL cholesterol. While a strong trend was demonstrated the changes in hs-CRP and SAA with colchicine treatment were not statistically significant when analysed with a repeated measures one-way ANOVA analysis. There was no effect on upstream biomarkers interleukin 6, Tumour Necrosis Factor alpha or Interleukin 1 suggesting that any potential effect of colchicine on hs-CRP and SAA occurs at the level of the hepatocyte. In addition colchicine had no effect on brachial Flow Mediated Dilation (FMD), a surrogate marker of cardiovascular risk, and the change in hs-CRP and SAA did not correlate with the change in FMD during colchicine treatment. While a negative study this work provides additional information on the effect of colchicine on inflammatory markers and novel information on the surrogate endpoint of FMD in a cohort with stable cardiovascular disease.
|Publication status||Unpublished - 2013|