Key result
Colchicine (0.5 mg/day) did not significantly reduce aortic wall vascular inflammation compared to placebo in patients with type 2 diabetes (ΔSUVmean -1.0%; 95% CI -7.1 to 5.1; p=0.75).
Why the study?
Colchicine reduces cardiovascular risk in clinical trials, but the mechanisms underlying these beneficial effects remain unclear, including its effect on vascular inflammation in type 2 diabetes.
Does colchicine reduce vascular inflammation in patients with type 2 diabetes and cardiovascular disease or high risk?
RCT (n=30)
Double-blind
1:1
Does colchicine reduce vascular inflammation in patients with type 2 diabetes and cardiovascular disease or high risk?
Low-dose colchicine did not significantly reduce vascular inflammation assessed by [18F]FDG-PET/CT in patients with type 2 diabetes and high cardiovascular risk, suggesting its cardioprotective effects may not be predominantly mediated by reducing vascular inflammation.
No reduction in vessel wall SUVmean with colchicine; challenges vessel wall inflammation as mediator of its cardiovascular benefit.
: Background Colchicine, an anti-inflammatory drug, has been shown to reduce cardiovascular risk in clinical trials, but the mechanisms underlying these beneficial effects remain unclear. Chronic low-grade inflammation is a hallmark of type 2 diabetes and linked to both micro- and macrovascular complications. In this study, we investigated the effect of colchicine on vascular inflammation using [ 18 F]fluorodeoxyglucose positron emission tomography/computed tomography ([ 18 F]FDG-PET/CT). Methods In this randomized, double-blind, placebo-controlled trial, we included 30 participants with type 2 diabetes and either cardiovascular disease or a high risk hereof. Participants were randomized to colchicine (0.5 mg/day) or placebo for 26 weeks in a 1:1 ratio. Vascular inflammation in the aortic wall was assessed using dynamic multiparametric [ 18 F]FDG-PET/CT, measuring standardized uptake values (SUV mean ), metabolic rate of glucose uptake (MR FDG ), and target-to-background ratio (TBR). Results Colchicine treatment did not result in significant changes in vessel wall SUV mean (ΔSUV mean : -1.0% (95% CI: -7.1;5.1, p = 0.75)), MR FDG (ΔMR FDG : -0.5% (95% CI: -19.7;18.7, p = 0.96)), or TBR (ΔTBR: 0.01 (95% CI: -0.17;0.20, p = 0.88)) compared to placebo. Both groups demonstrated excellent adherence and comparable safety profiles. Conclusion In this pilot substudy, low-dose colchicine was not associated with measurable reductions in vascular inflammation in patients with type 2 diabetes, as assessed by dynamic multiparametric [ 18 F]FDG-PET/CT. While the limited sample size precludes exclusion of small to moderate treatment effects, these findings suggest that reductions in vascular inflammation are unlikely to be the predominant mechanism underlying the cardioprotective effects of colchicine, particularly in populations with low inflammatory burden.
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Baier et al. (2026) conducted an RCT in Type 2 diabetes (n=30). Colchicine vs. Placebo was evaluated on Vascular inflammation in the aortic wall (vessel wall SUVmean) (ΔSUVmean -1.0%, 95% CI -7.1 to 5.1, p=0.75). Colchicine (0.5 mg/day) did not significantly reduce aortic wall vascular inflammation compared to placebo in patients with type 2 diabetes (ΔSUVmean -1.0%; 95% CI -7.1 to 5.1; p=0.75).
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