Aernoud Fiolet

97 The LoDoCo2 trial rationale, design, and baseline characteristics Figure 2. Colchicine effects in monocytes. Detail of the effect of colchicine on macrophage and monocyte activation showing how its effects on tubulin inhibits the assembly of the Nucleotide-binding oligomerization domain, Leucine rich Repeat and Pyrin domain containing (NLRP3) inflammasome resulting in upstream inhibition of the pivotal pro-inflammatory cytokines. IL, interleukin; TNF-A, tumor necrosis factor-A. There is mounting evidence that colchicine's effects on the cellular processes continually at play in the vascular bed may translate into clinically meaningful benefits (Figure 3, Table I). Animal studies have demonstrated that colchicine can inhibit the development of atherosclerosis independent of statin therapy and observational studies inman indicate that low-dose colchicine can favorablymodify plaque morphology and reduce stent stenosis. 11,23-29 Furthermore, the LoDoCo pilot demonstrated for the first time in a randomized study that colchicine 0.5 mg daily could safely reduce the risk of CV events in patients with stable coronary disease. 30 Together, these data justify a rigorous randomized controlled trial to confirm whether low-dose colchicine can be repurposed as a safe and effective treatment for secondary prevention in patients with stable coronary artery disease.