Colchicine reduces inflammatory cytokines and improves symptoms in HFpEF: an observational pilot study

Objective The objective of this study was to investigate whether colchicine could safely and effectively reduce inflammatory marker levels and improve the prognosis in patients with heart failure with preserved ejection fraction (HFpEF). Methods This study enrolled patients diagnosed with HFpEF. Venous blood samples were collected to assess the levels of inflammatory markers such as IL-6, IL-8, and TNF-α. If these markers were elevated, patients were treated with colchicine 0.5 mg once daily. Inflammatory markers were reassessed after 2 weeks of treatment in the outpatient department. The primary endpoint was the change in inflammatory factor levels before and after colchicine treatment. Secondary outcomes included assessments of anxiety (HAMA), depression (HAMD), and quality of life (KCCQ) after 1 month of colchicine treatment. The clinical trial was registered at Chinese Clinical Trail Registry (ChiCTR2500103522). Results A total of 126 patients were included. The serum inflammatory markers most notably elevated in the HFpEF cohort were IL-8 and IL-6, with IL-8 showing the most significant increase. After 2 weeks of colchicine treatment, serum levels of inflammatory markers decreased significantly. IL-8 levels decreased by −28.65 (95% CI: −54.20 to −11.47, p = 0.0010), a 65.5% reduction (95% CI: −82.0% to −45.0%). IL-6 levels decreased by −1.925 (95% CI: −4.510 to −0.29, p = 0.0028), reflecting a 30.5% reduction (95% CI: −54.0% to −5.0%). After 1 month of colchicine treatment, patients’ overall quality of life improved significantly. Anxiety (HAMA) decreased by −1 (95% CI: −1.0 to −1.0, p < 0.0001), depression (HAMD) decreased by −1 (95% CI: −1.0 to 0.0, p < 0.0001), and quality of life (KCCQ) increased by 10 points (95% CI: 9.0 to 12.0, p < 0.0001). Conclusion This study is the first to explore colchicine as an anti-inflammatory treatment for HFpEF. Our results indicate that colchicine can safely and effectively reduce inflammatory markers such as IL-8 and IL-6. After 1 month of treatment, significant improvements were observed in anxiety, depression, and quality of life. These findings support colchicine’s potential as a therapeutic option for managing inflammation and improving outcomes in patients with HFpEF.