A common gout drug may unexpectedly lower the risk of heart attacks and strokes, according to a major new review

A commonly used and affordable medication for gout may help lower the risk of heart attacks and strokes in people withcardiovascular diseaseaccording to a new Cochrane review.

In this analysis, researchers evaluated the impact of low-dose colchicine, a long-established gout treatment, and found no evidence of an increase in serious adverse effects.

Chronic, low-level inflammation plays a major role in heart disease and often contributes to repeated cardiovascular events, including heart attacks and strokes. Because colchicine works by reducing inflammatory activity, scientists are exploring its potential benefits for individuals already living with heart conditions.

A promising effect on cardiovascular risk

The review assessed 12 randomized controlled trials that followed nearly 23,000 participants with a history of heart disease, heart attack, or stroke. All studies involved patients who took colchicine for at least six months at doses of 0.5 mg once or twice daily.

About 80% of the participants were male, with ages ranging from 57 to 74 years. Half of the group received colchicine, while the remaining participants were given a placebo or continued their standard care without additional treatment.

Overall, those taking low-dose colchicine were less likely to experience a heart attack or stroke. For every 1,000 people treated, there were 9 fewer heart attacks and 8 fewer strokes compared with those not taking the drug. Whilst there were no serious adverse events identified, patients who took colchicine were likely to have stomach or digestive side effects, but these were usually mild and didn’t last long.

“Among 200 people with cardiovascular disease – where we would normally expect around seven heart attacks and four strokes – using low-dose colchicine could prevent about two of each,” says Dr. Ramin Ebrahimi, co-lead author from the University Medicine Greifswald, Germany. “Reductions like this can make a real difference for patients who live with ongoing, lifelong cardiovascular risk.”

A new use for a long-established medicine

As cardiovascular diseases are the leading cause of death globally, colchicine presents a promising inexpensive and accessible option for secondary prevention in high-risk patients.

“These results come from publicly funded trials repurposing a very old, low-cost drug for an entirely new use,” says Lars Hemkens, senior author from theUniversity of BernSwitzerland. “It shows the power of academic research to reveal treatment opportunities that traditional drug development often overlooks.”

The evidence is less clear when it comes to whether colchicine affects overall death rates or the need for procedures like coronary revascularization. The studies didn’t provide any information to say whether the drug improves quality of life or reduces hospital stays. The authors stress that further research is needed in these areas.

Reference: “Colchicine for the secondary prevention of cardiovascular events” by Fahim Ebrahimi, Ramin Ebrahimi, Maximilian Beer, Christof Manuel Schönenberger, Hannah Ewald, Matthias Briel, Perrine Janiaud, Julian Hirt and Lars G Hemkens, 13 November 2025,Cochrane Database of Systematic Reviews.
DOI: 10.1002/14651858.CD014808.pub2

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