Correspondence on ‘Colchicine and coronary inflammation: absence of evidence is not evidence of absence’ by Aernoud T L Fiolet et al

Inflammation has been implicated in the pathophysiology of plaque formation and rupture, while anti-inflammatory treatment with colchicine may be associated with cardiovascular risk reduction.1 2 However, evidence from large randomised clinical trials remains inconclusive (eg, the findings of the CLEAR SYNERGY (OASIS 9),3 and there is limited data on the direct vascular effects of colchicine. An optical coherence tomography study has indicated that colchicine may stabilise coronary atheromas by increasing fibrous cap thickness,4 while a study that assessed coronary plaques by coronary CT angiography (CCTA) showed a reduction in inflammation-driven low-attenuation plaque volume.5