World-first exploratory research from the Heart Research Institute in Sydney suggests an inexpensive gout drug may have a therapeutic role in people who have had an MI.

Colchicine is a potent anti-inflammatory drug that is approved for the management of patients with acute gout, and other inflammatory conditions such as pericarditis, the researchers from the Cell Therapeutics Group at the HRI noted in the study published in the Journal of the American Heart Association.

The research team hypothesised that the anti-inflammatory properties of the drug may also suppress inflammatory cytokines that are raised in patients who have had a myocardial infarction.

The group randomised 40 ACS patients, 33 with stable coronary artery disease, and 10 controls  to oral colchicine before performing a coronary angiogram.

They saw a rapid and significant drop in levels of interleukin-1 and interleukin-18 within the coronary arteries, as well as a drop in interleukin-6 in patients who had been given the gout drug.

“This is an exciting finding as IL-6 is precursor to C-reactive protein, or CRP, which is significantly associated with the incidence of future cardiovascular events in patients with atherosclerosis,” said study lead Dr Sanjay Patel.

Exactly how colchicine inhibits the production of inflammatory cytokines is not completely understood but the team believes the drug works by blocking the NLRP3 inflammasome, a protein complex within immune cells responsible for the production of active IL-1 and IL-18.

“The next step will be to prove clinical effect through rigorous multi-centre clinical trials,” explains Dr Patel.  “If it works we have a cheap yet potent treatment with very important therapeutic implications for heart patients.”

HRI collaborated with researchers from Royal Prince Alfred Hospital, the University of Sydney, Catholic University School of Medicine, Santiago, the Paris-Cardiovascular Research Centre and the University of Cambridge.