Colchicine significantly reduced IL-6 levels (decreasing to 11.2 pg/mL vs an increase with placebo; P<0.001) and improved left atrial mechanical function in rheumatic mitral valve disease.
RCT (n=90)
Double-blind
1:1
Does colchicine reduce interleukin (IL)-6 at 6 months in patients with chronic moderate-to-severe rheumatic mitral valve disease?
Colchicine significantly attenuates systemic inflammation and improves left atrial mechanical function and NYHA functional status in patients with chronic rheumatic mitral valve disease.
p-value: p=<0.001
BACKGROUND: Rheumatic heart disease is increasingly recognized as an immunologically active condition characterized by persistent low-grade inflammation contributing to atrial dysfunction. OBJECTIVES: The authors aimed to evaluate whether colchicine reduces systemic inflammation and improves left atrial (LA) mechanical function in chronic rheumatic mitral valve disease. METHODS: In this prospective, double-blind, randomized controlled trial, 90 patients with chronic moderate-to-severe rheumatic mitral valve disease were randomized (1:1) to colchicine (0.5 mg twice daily) or placebo for 6 months in addition to standard therapy. The primary outcome was change in interleukin (IL)-6 at 6 months. Secondary outcomes included changes in other inflammatory markers, LA strain parameters, NYHA functional class, and correlations between inflammatory markers and LA mechanics. RESULTS: Colchicine significantly reduced inflammatory markers (IL-6, high-sensitivity C-reactive protein, erythrocyte sedimentation rate; all P < 0.001). IL-6 decreased from 98.0 (86.9-112.1) to 11.2 (7.3-21.5) pg/mL in the colchicine group, while increasing in placebo (P < 0.001). LA reservoir strain improved significantly (23.6% ± 2.0% vs 16.5% ± 1.6%, P < 0.001). IL-6 showed strong inverse correlation with LA reservoir strain (r = -0.65, P < 0.001). Functional status improved, with 69.2% of NYHA functional class III patients improving to class II. CONCLUSIONS: Colchicine significantly attenuates systemic inflammation and improves LA mechanical function and functional status in chronic rheumatic mitral valve disease, supporting an inflammation-driven atrial myopathy phenotype.
Gupta et al. (Wed,) conducted a rct in chronic moderate-to-severe rheumatic mitral valve disease (n=90). Colchicine vs. placebo was evaluated on change in interleukin (IL)-6 at 6 months (p=<0.001). Colchicine significantly reduced IL-6 levels (decreasing to 11.2 pg/mL vs an increase with placebo; P<0.001) and improved left atrial mechanical function in rheumatic mitral valve disease.