Anti-inflammatory Medication for ASCVD - Attia

[DeStrider]

First anti-inflammatory medication approved for treatment of ASCVD

Colchicine

[约瑟夫]

FWIW

This {colchicine] was discussed in this forum weeks ago when the paper was making the news.

心血管健康

First drug ever approved for prevention of vascular events based on an anti-inflammatory mechanism. Standard dose of cheap generic colchicine is 0.6mg, but the pharmaceutical company used a 0.5mg dose so they can patent it (granted, that’s probably the only way the studies could get done on an old medication to get it approved in the first place).

心血管健康

FWIW During the early part of COVID,. I recall a small study/treatment using colchicine to treat the “inflammatory mechanism”. The person who published/did the work was discounted and ostracized. He was correct, yet will not be recognized.

心血管健康

From the above posted article, link to copy of on of the referenced papers, titled; “Efficacy and Safety of Low-Dose Colchicine after Myocardial Infarction” https://www.nejm.org/doi/10.1056/NEJMoa1912388

[RapAdmin]

Inflammation is such a universal feature of aging I have to wonder if it might be something the ITP may want to try at some point (obviously, more preliminary testing needs to be done prior to that).

I also wonder about its value in prevention as people get older. As usual, its cheap as dirt from the regular Indian suppliers - about $0.50 for 10 tablets (0.5 mg each tablet). (82 rupees to the US$).

[KarlT]

Interesting that the dose being sold is 0.5 which is the dose used in the study but not the standard dose for colchicine (0.6 or 1.2)

[sluggerT80]

Just a way for the pharma company who paid for the study to patent the 0.5 mg dose as a brand name drug and charge a crazy high price. Business as usual.

[约瑟夫]

At Walmart {yes, prescription is required]

Generic Colchicine

      30 tablets 0.6mg

$23.00{the is in North New Jersey area] with a discount card from GoodRx

The cost changes by zip code.

[KarlT]

@sluggerT80

Just a way for the pharma company who paid for the study to patent the 0.5 mg dose as a brand name drug and charge a crazy high price. Business as usual.

Doesn’t explain why that is the dose in India

[essexaid]

0.5mg seems to be the standard generic dose for Colchicine everywhere that I’ve seen, except apparently in the USA. Maybe it’s just like Aspirin where the standard USA dose is 325mg but everywhere else it’s 300mg?

[JuanDaw]

Best to read the article, instead of the headline.

We should also point out that patients in this trial had a fairly advanced form of coronary disease. Therefore, results only speak to that population, and we don’t yet have any data on colchicine’s effects at earlier stages of disease, which might inform optimal timing and context of colchicine treatment. For instance, would starting treatment earlier slow the decades-long process of ASCVD progression and result in greater benefits, as we see with lipid-lowering medications? Or perhaps does colchicine merely stabilize existing plaques?

we cannot be certain that colchicine and placebo groups were truly at equivalent risk at baseline, nor can we know if the observed protection afforded by colchicine treatment was in fact due to a reduction in systemic inflammation.

[sluggerT80]

They don’t care what the dose is in India, they care what the dose is in the US where they make all the $$$ off of putting a brand name on a decades old drug.