Colchicine and cardiovascular events: An updated meta-analysis of published randomized controlled trials

Background: Colchicine shows promise in reducing cardiovascular risk, but a recent study raised the question whether this is really the case. We conducted a meta-analysis of randomized controlled trials (RCTs) to assess its impact on cardiovascular outcomes in secondary prevention. Methods: We systematically searched major databases up to March 2025 for RCTs comparing colchicine to placebo over a treatment duration of ≥12 months, reporting major adverse cardiovascular events (MACEs). Both fixed- and random-effects models were used to compute pooled risk ratios (RRs) and 95% confidence intervals. Results: Six RCTs comprising 21,774 patients were included. Colchicine significantly reduced the risk of MACEs (RR 0.74 [0.60–0.92]) and specific components of primary outcome (myocardial infarction, RR 0.85 [0.73–0.98]; stroke, RR 0.79 [0.65–0.95]), with no significant effect on cardiac death and revascularization. Conclusion: These results support the efficacy of low-dose colchicine in reducing MACEs when added to standard care for at least 12 months.