Colchicine as adjunctive therapy in heart failure: a pooled analysis

Background Colchicine has shown anti-inflammatory benefits in cardiovascular disease, but its role in heart failure (HF) remains unclear. This systematic review assesses the efficacy of colchicine as an adjunct therapy in heart failure. Methods A systematic search identified randomized controlled trials (RCTs) assessing colchicine in heart failure, focusing on New York Heart Association (NYHA) functional status, a composite outcome of death and hospitalization, and inflammatory markers including interleukin-6 (IL-6) and C-reactive protein (CRP). Results Two RCTs (Deftereos et al., 2014 and COLICA, 2024) involving 545 patients met the inclusion criteria. Neither study reported a statistically significant change in NYHA functional status or change in relative risk for the composition of death and HF hospitalization in treating HF with colchicine. Both studies did show a statistically significant change in biomarkers such as CRP and IL-6. Conclusions While colchicine did not significantly impact clinical endpoints such as death, hospitalization, or NYHA functional status, it demonstrated a significant reduction in inflammatory markers (CRP and IL-6). These findings are derived from only two RCTs (N = 545) and should be interpreted with caution. Further studies are warranted to clarify its role in HF management.