Reacción a "Colchicine use reduces strokes and heart attacks in people with cardiovascular disease, according to a Cochrane review"

This work is necessary precisely because it is a high-quality meta-analysis, endorsed by Cochrane, at a time when sufficient clinical trials exist to establish a solid and critical level of evidence on the value of colchicine as an anti-inflammatory drug in cardiovascular disease.

While clinical trials exist, the results have shown some heterogeneity. Overall, the results have been favorable, and American guidelines have recommended low-dose colchicine in patients with high cardiovascular risk to a greater degree than European guidelines, which recommend it less strongly. In this context, this extensive, high-quality meta-analysis provides new evidence, as it combines the information from all these individual trials and translates it into a comprehensive view of the drug's benefits and adverse effects within the broader context of cardiovascular, coronary, and cerebrovascular disease.

The main limitation is inherent to the individual trials themselves: the benefit is moderate and predominant in patients with ischemic heart disease (previous myocardial infarction), but we likely lack data on which subgroups of patients may benefit most. In particular, colchicine is an anti-inflammatory drug, and it would be relevant to identify markers that would help to individualize or personalize this treatment in those patients in whom this mechanism is predominant in their cardiovascular risk.