First Drug to Prevent Heart Disease Is Approved

Doctors have long known that inflammation plays a significant role in triggering heart attacks and strokes. Now for the first time, an anti-inflammatory drug is on the market to prevent these cardiovascular events.

“It is a game changer,” says Ian Neeland, MD, Director of Cardiovascular Prevention at University Hospitals Harrington Heart & Vascular Institute.

“We’ve known that low-grade, systemic inflammation is a powerful determinant of recurrent cardiovascular events. Colchicine is the first drug we have on the market for inflammation that reduces this risk,” says Dr. Neeland.

An Old Drug With A New Use

Colchicine is an older drug that has traditionally been prescribed for gout and other inflammatory conditions. The Food and Drug Administration (FDA) approved colchicine for heart disease prevention in June of 2023.

Sold under the brand name Lodoco, colchicine can now be used in addition to cholesterol and blood pressure medications to reduce the risk of heart disease and stroke. The drug is for patients who have established coronary artery disease and those who have had a heart attack or stroke and are at risk for a recurrence.

The Role of Inflammation in Heart Disease

Inflammation can promote the growth of fatty plaque in the arteries and also raise the risk of plaque breaking loose and forming blood clots that cause heart attacks and strokes.

Certain health conditions as well as lifestyle factors can increase inflammation in the body. They include:

• Chronic inflammatory conditions such as diabetes and HIV/AIDS, and a number of autoimmune diseases such as lupus, psoriasis and rheumatoid arthritis.
• Poor diet, smoking, stress, heavy drinking and excess body weight.

A simple blood test (high sensitivity C-reactive protein) can measure inflammation in the body and may be used to guide colchicine treatment in some patients.

“Inflammation can be more informative than cholesterol in certain patients,” says Dr. Neeland. “Even with someone who has a very low cholesterol level, an elevated inflammation level is predictive of cardiovascular events.”

Colchicine works by inhibiting white blood cells that cause inflammation. In a clinical trial of more than 5,000 patients with coronary artery disease, low-dose colchicine taken daily reduced risk of cardiovascular events by 31 percent compared to standard treatment.

Is Colchicine for You?

Dr. Neeland says colchicine is not for every patient. Medications to control cholesterol, blood pressure and blood sugar remain first-line treatments to prevent heart attack and stroke.

Colchicine is for heart patients who have their cholesterol, blood pressure and blood sugar under control, but who nonetheless have had a heart attack or stroke or remain at high risk.

The most common side effects of the drug are diarrhea and gastrointestinal upset, but those effects are usually not seen with low doses used for heart disease prevention, Dr. Neeland says.

Patients with heart disease should talk to their cardiologist about inflammation and whether colchicine is right for them, he says.

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The experts at University Hospitals Harrington Heart & Vascular Institute have the advanced training and experience to diagnose and treat all types of cardiovascular conditions, including hypertension. Our expertise ranges from the management of chronic diseases to the most complex open heart surgical procedures – and everything in between.