A crocus remedy for swollen joints from 1500 BC now protects hearts
Extracts of the autumn crocus were eased onto aching joints some 3,500 years ago. Their active compound, colchicine, is still a mainstay for gout, and in 2023 American regulators approved a low daily dose to cut heart attacks and strokes in people with cardiovascular disease, even though nobody knows exactly how it helps.
American regulators cleared colchicine as a medicine in 1961, and it is now a cheap generic; in 2023 it ranked 215th among American prescriptions, with more than 2 million written. It dampens inflammation through several routes at once. The American College of Rheumatology lists it alongside anti-inflammatory painkillers and steroids for gout, and it offers an option for patients who cannot tolerate NSAIDs. Low doses appear to relieve attacks about as well as those drugs, whereas bigger doses cause diarrhoea, nausea and vomiting.
The heart story is newer. In June 2023 the FDA approved a 0.5 mg daily product called Lodoco for adults with existing cardiovascular disease. In trials it lowered the rate of cardiovascular events by 31 percent in people with established atherosclerosis and by 23 percent after a recent heart attack, working best alongside cholesterol-lowering and other anti-inflammatory treatment. It also helps prevent atrial fibrillation following heart surgery.
The drug appears in a surprisingly long list of other conditions. It reduces attacks of familial Mediterranean fever and lowers the long-term risk of amyloidosis that disease carries, serves as a long-term treatment for Behcet's disease, and features in therapy for pericarditis and pseudogout, though for many of these uses formal studies of its effectiveness are lacking.
Its margin of safety is narrow, so the gap between a helpful and a harmful amount is small. Serious effects can include collapsing blood cell counts and breakdown of skeletal muscle, and overdoses can kill. Injected forms proved so toxic that the FDA removed them all from the American market in 2008; the medicine is now taken by mouth. Outside medicine, plant breeders use colchicine to double chromosome counts, producing larger, sturdier, faster-growing plants than their diploid parents.
Source: Colchicine
