Evidence-based progress and clinical enlightenment of low-dose colchicine in secondary prevention of atherosclerotic cardiovascular disease
- VernacularTitle:低剂量秋水仙碱在动脉粥样硬化性心血管疾病二级预防中的循证进展及临床启示
- Author:
Xianghong WANG
1
;
Jinxia ZHANG
2
;
Rui LI
2
;
Ge GUAN
2
;
Xue GONG
2
;
Mengmiao ZHANG
3
;
Bo JI
4
;
Jian LI
5
;
Zhihui JIANG
3
Author Information
1. Hongkang Dayihui General Outpatient Department，Guangzhou 510010，China
2. Dept. of Cardiovascular Medicine，General Hospital of Southern Theater Command，Guangzhou 510010，China
3. School of Pharmaceutical Sciences，Southern Medical University，Guangzhou 510515，China
4. Dept. of Pharmacy，General Hospital of Southern Theater Command，Guangzhou 510010，China
5. Dept. of Pharmacy，Shenzhen University of Advanced Technology General Hospital，Guangdong Shenzhen 518000，China
- Publication Type:Journal Article
- Keywords:
Colchicine;
Low-dose;
atherosclerotic cardiovascular disease;
Secondary prevention;
Inflammation;
residual inflammatory risk;
clinical guidelines;
Off-label use
- From:
China Pharmacy
2026;37(19):2608-2614
- CountryChina
- Language:Chinese
-
Abstract:
Residual inflammatory risk （RIR） is a key issue to be urgently addressed in the secondary prevention of atherosclerotic cardiovascular disease （ASCVD）. Targeted intervention of RIR has become a novel target for drug development and clinical management. A series of high-quality randomized controlled trials （RCTs）， including COLCOT， LoDoCo2 and CLEAR SYNERGY， provided high-level evidence and confirmed that low-dose colchicine （0.5 mg/d） significantly reduced the risk of cardiovascular events in ASCVD patients at stable stage or after the acute phase， while its efficacy varied in different clinical scenarios. International authoritative guidelines from the European Society of Cardiology and the American Heart Association/American College of Cardiology include low-dose colchicine in the recommendations for ASCVD secondary prevention. Two domestic guidelines released in 2024， namely the Guideline for the Diagnosis and Treatment of Non-ST-Segment Elevation Acute Coronary Syndrome （ 2024 ） and the Guideline for the Diagnosis and Management of Chronic Coronary Syndrome in China ， have also added relevant recommendations. Nevertheless， due to potential racial differences， safety concerns regarding drug-drug interactions， and the relative lack of clinical evidence in China， especially the absence of prospective RCTs using low-dose colchicine for secondary prevention of ASCVD patients， current clinical recommendations still mainly based on international evidence and guidelines， and should not be simply extrapolated.
