Study investigates gout medication for improving outcomes after heart attacks

Professor Jamie Layland

by Jessica Mills, Peninsula Health

Research investigating the impact of common gout medication Colchicine, in patients with acute coronary syndrome, led by Peninsula Health and Monash University cardiologist Professor Jamie Layland, has been published in premier cardiology journal Circulation.

The COPS Trial (COlchicine in Patients with Acute Coronary Syndromes) is a multicentre, double-blind, randomised, placebo-controlled trial to assess the impact of low-dose colchicine on long-term cardiovascular outcomes in patients presenting with acute coronary syndromes. This is the first Australian multi-centered clinical trial to be led by Peninsula Health.

“There is a recurrent rate of heart attacks, strokes and death after you have a heart attack. That risk is approximately 20% and we are always trying to reduce that risk,” explains Professor Layland.

“One of the factors that contributes this ongoing risk is inflammation. We know that patients who have a higher level of inflammation after a heart attack tend to do worse. So we have been trying to target inflammatory pathways to see if this will improve outcomes.”

“Colchicine is a commonly used gout tablet which is a broadly acting anti-inflammatory agent. Previous trials have shown that this has had benefit in patients with heart disease. We performed this trial to see if it reduced recurrent events after a heart attack.”

Professor Layland, together with PhD student Dr David Tong, began the investigator-initiated trial, with limited funding from Peninsula Health but without backing from a pharmaceutical company.
The trial ran over 17 centres in Australia, including many Monash University sites, with 795 patients taking part. Half of the patients were given Colchicine, the other half placebo.

The paper in Circulation details the research findings over the first 12 months of follow-up with these patients.

“We showed that over the 12 months, although there was a numerically lower number of events in the Colchicine group, it didn’t meet the threshold for being significant,” explains Professor Layland.

“The longer followup data is promising, as it suggests there is a cumulative effect of the Colchicine. We hope in the two-year data the effect will be much greater.”

Reference: https://www.ahajournals.org/doi/10.1161/CIRCULATIONAHA.120.050771

The COPS Trial was selected as a late-breaking clinical trial at the European Society of Cardiology conference, Amsterdam 2020. Professor Layland presented the findings from the study at the conference on 29 August.