Colchicine Reduces hsCRP, sST2 in HFpEF, May Have Anti-Inflammatory Effect

Colchicine has successfully reduced hsCRP, sST2, and interleukin-6 (IL-6) in patients with heart failure with preserved ejection fraction (HFpEF) over 12 weeks, highlighting its anti-inflammatory effect.¹

These data were presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026 in Phoenix, Arizona, by Anastasia Shchendrygina, MD, PhD, associate professor at I.M. Sechenov First Moscow State Medical University.¹

“To date, we don’t have any guidelines regarding this high sensitivity therapy measurement in this patient population,” Shchendrygina told HCPLive in an exclusive interview. “I think the results of our study are the first step to further investigate whether this is a reliable biomarker and if it can provide any guide for us in terms of future therapeutic intervention.”

Shchendrygina and colleagues conducted a single-center, prospective, randomized, open-label, blinded-endpoint crossover trial assessing the effects of colchicine on inflammation-related biomarkers of HFpEF. Patients ≥40 years with New York Heart Association (NYHA) class 2-3 HFpEF and left ventricular ejection fraction >50%, elevated NT-proBNP, and signs of a pro-inflammatory HF phenotype (defined as hsCRP >2 mg/L, body mass index [BMI] ≥30 kg/m2, or diabetes) were eligible for enrollment. Those with recent HF decompensation or active or chronic inflammatory disease were excluded.^1,2

Enrolled patients were randomly assigned in a 1:1 ratio to receive either colchicine 0.5 mg twice daily or standard-of-care. Given that no placebo was utilized in the study, both patients and investigators were unblinded to treatment. After the first 12 weeks of treatment, patients were crossed over to the opposite treatment with a 2-week washout period for another 12 weeks of treatment. The co-primary endpoints were between-treatment mean differences in change in hsCRP and sST2. Key secondary endpoints included IL-6 and echocardiographic parameters, such as LV diastolic function, right ventricular systolic function, and cardiac remodeling.^1,2

A total of 42 patients were enrolled and randomized – of these, 3 were lost to follow-up, leaving 39 patients with full study data accessible. Mean age among these patients was 65.1 years (+/- standard deviation [SD], 6.8 years), and mean BMI was 34.3 kg/m2 +/- 6.1. 30 patients had NYHA class 2 HF, while 12 had class 3, and all 42 patients had hypertension at baseline.¹

By the end of the trial, Shchendrygina and colleagues recorded a substantial reduction in both hsCRP and sST2 with colchicine treatment. The former saw a between-treatment mean difference of -2.55 mg/L (97.5% CI, -3.28 to -1.82; P <.001), with a 57% relative reduction. The latter saw a between-treatment mean difference of -1.62 ng/mL (97.5% CI, -3.11 to -0.12; P = .016), with a relative reduction of 6%. There was no significant treatment-by-period interaction for either sST2 or hsCRP (both P = .86), and exploratory subgroup analyses were consistent across age, sex, obesity, diabetes, and use of SGLT2 inhibitors.¹

Shchendrygina and colleagues also noted a significant reduction in multiple secondary endpoints, including IL-6. This inflammatory biomarker saw a between-treatment difference of -1.22 pg/mL (95% CI, -1.52 to -0.87; P <.001), with a 52% relative reduction. Additionally, NT-proBNP saw a between-treatment mean difference of -30.57 (95% CI, -98.33 to 37.18; P = .366).¹

Ultimately, the team concluded that colchicine treatment led to a substantial reduction in both co-primary endpoints over 12 weeks, while also lowering IL-6 and supporting the drug’s potential anti-inflammatory effect. However, these changes were not accompanied by improvements in cardiac structure, function, or functional capacity.¹

“At this stage, I would say our study is hypothesis-generating data, which need further investigation in a larger, multi-center study,” Shchendrygina said. “Further studies are needed to go further with this drug in this patient population.”

Editors’ Note: Shchendrygina reports no relevant disclosures.

References

1. Shchendrygina A, Sitnikova V, Ferreira JP, et al. Colchicine in patients with heart failure and preserved ejection fraction: a crossover trial. Presented at the Heart Failure Society of America (HFSA) Annual Scientific Meeting 2026, Phoenix, AZ. October 9-12, 2026.

2. Shchendrygina A, Rachina S, Cherkasova N, et al. Colchicine in patients with heart failure and preserved left ventricular ejection fraction: rationale and design of a prospective, randomised, open-label, crossover clinical trial. Open Heart. 2023;10(2):e002360. doi:10.1136/openhrt-2023-002360