Colchicine's Multifaceted Therapeutic Potentials Beyond Gout: Mechanism, Applications, and Future Perspectives
TL;DR
The expanding clinical evidence supporting colchicine's use in conditions such as pericarditis, coronary artery disease, COVID‐19, Behçet's disease, liver cirrhosis, and certain cancers is summarized.
Abstract
Colchicine has long been recognized for its efficacy in the treatment of gout and familial Mediterranean fever (FMF). However, recent advances in pharmacological and clinical research have illuminated its far‐reaching therapeutic potential beyond traditional indications. Colchicine exerts a wide range of biological effects, including inhibition of leukocyte chemotaxis, suppression of the NOD‐, LRR, and pyrin domain‐containing protein 3 (NLRP3) inflammasome, and modulation of inflammatory cytokine release. This review provides an in‐depth examination of colchicine's molecular mechanisms of action and their relevance to disease modulation. We summarize the expanding clinical evidence supporting its use in conditions such as pericarditis, coronary artery disease, COVID‐19, Behçet's disease, liver cirrhosis, and certain cancers. The manuscript also explores colchicine's pharmacokinetics, safety profile, drug–drug interactions, and the challenges associated with its narrow therapeutic index. Special attention is given to ongoing clinical trials and real‐world data that underscore its utility in diverse patient populations. Finally, we discuss future perspectives, including opportunities for drug repurposing, targeted delivery systems, and the potential for colchicine to serve as a model for developing novel anti‐inflammatory agents. As our understanding of its multifaceted actions deepens, colchicine continues to evolve for versatile therapeutic tool with broad clinical implications across multiple disciplines.