The potential of colchicine for lowering the risk of cardiovascular events in type 1 diabetes.

Nicklas Järvelä Johansen, Filip Krag Knop

European heart journal. Cardiovascular pharmacotherapy 2023 Jun 02

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In type 1 diabetes, average life expectancy is reduced by ˃10 years as compared with outside of diabetes. Residual cardiovascular risk defines high cardiovascular event rate despite modern, guideline-recommended standard of care of established risk factors like hypertension, dyslipidaemia, and glycaemic control, and it adds importantly to these lost years of life in type 1 diabetes due to atherosclerotic cardiovascular diseases like myocardial infarction and ischaemic stroke. With a growing understanding of inflammation as an important driver of atherosclerotic cardiovascular disease, residual inflammatory risk is a novel and common risk factor and a promising target for lowering residual cardiovascular risk in type 1 diabetes. Interestingly, the inexpensive anti-inflammatory agent colchicine reduced the risk of major adverse cardiovascular events by 25% in cardiovascular outcome trials in the secondary prevention of atherosclerotic cardiovascular disease. Here, we summarize the role of inflammation as a driver of atherosclerosis and review current evidence linking inflammation and atherosclerotic cardiovascular disease in type 1 diabetes. Also, we provide an overview of the evidence base for targeting residual inflammatory risk with colchicine for lowering residual cardiovascular risk in type 1 diabetes. © The Author(s) 2023. Published by Oxford University Press on behalf of the European Society of Cardiology.

Citation

Nicklas Järvelä Johansen, Filip Krag Knop. The potential of colchicine for lowering the risk of cardiovascular events in type 1 diabetes. European heart journal. Cardiovascular pharmacotherapy. 2023 Jun 02;9(4):311-317