Researchers from Nottingham University have found that taking colchicine, an anti-inflammatory medicine, reduces the risk of heart attacks and strokes in the first six months after starting urate-lowering medicines, such as allopurinol and febuxostat.

Urate-lowering treatment can initially increase the risk of gout flares (attacks) and colchicine is therefore often recommended to prevent these flares.

Published in the Lancet Rheumatology, the study analysed medical (hospital and death) records of UK gout patients who began urate-lowering therapy for the first time between 1997 and 2023. It compared those prescribed colchicine for at least 21 days with those who weren’t.

Out of 111,460 patients, 99,800 started urate-lowering therapy. Among them, 25,511 were women and 74,289 were men, with an average age of about 63 years. Around 4.1% had previous heart problems, and 16.1% were given colchicine.

The study found that patients who took colchicine had had a significantly lower risk of heart attacks and strokes compared to those who didn’t. Specifically, there were about 29 heart events per 1,000 people per year in the colchicine group, compared to about 35 per 1,000 people per year in the group without colchicine. This means colchicine users had 6.5 fewer heart events per 1,000 people per year. The results were consistent across different analyses.

The study is important because past studies have shown that the risk of heart attacks and strokes increases for about six months following a gout flare. These new findings provide an additional argument for giving colchicine to gout patients to prevent flares when they commence taking urate-lowering medicine.