Individuals with diabetes remain at high risk for major adverse cardiovascular events (MACE), and the role of colchicine in this population requires further evaluation despite its established benefit in broader cardiovascular settings. A systematic review and meta-analysis published in the Diabetes & Vascular Disease Research assessed cardiovascular outcomes and the safety of colchicine in patients with diabetes.

The analysis included randomized controlled trials identified through database searches up to November 2024. Five trials were included, comprising 2977 participants with diabetes, with 1492 receiving colchicine and 1485 receiving placebo or usual care. Most participants were men over 60 years of age. A fixed-effects inverse-variance model was used to calculate pooled hazard ratios and risk ratios.

Colchicine reduced MACE compared with control (HR 0.79; 95% CI 0.67-0.94; p=0.006). Subgroup analysis showed a similar effect in comparisons of diabetic and non-diabetic participants (HR 0.75; 95% CI 0.67-0.83; p<0.001). Treatment was administered at a dose of 0.5 mg daily over a median follow-up of 28.6 months.

No increase in adverse events was observed. Composite adverse events were lower with colchicine (RR 0.81; 95% CI 0.68–0.96; p=0.02), while gastrointestinal (RR 1.09; p=0.12) and musculoskeletal events (RR 0.77; p=0.39) were comparable between groups. These findings indicate that colchicine reduced MACE without an increase in adverse events in patients with diabetes.