Colchicine (Colcrys®) is a drug typically indicated for gout or familial Mediterranean fever that we learned about in one of our top drugs sessions. Colchicine is a microtubule disruptor, and it can also be used to reduce the occurrence of atrial fibrillation after someone undergoes an operation or ablation. There has not been much research completed on the effects of colchicine on atrial myocytes (cells in the heart muscle), so that is what this study aimed to find out.
The purpose of this study was to determine if colchicine can regulate calcium (Ca2+) homeostasis and reduce the electrical effects of the extracellular matrix on atrial myocytes. HL-1 cells are a specific type of muscle cell. In this study, HL-1 cells derived from mouse atrial muscle cells were treated with and without (control) colchicine over a 24 hour period.
The results of the study were that colchicine-treated HL-1 cells, in comparison to control cells, had a longer action potential duration with smaller intracellular Ca2+ transients and sarcoplasmic reticulum Ca2+ content by 10% and 47%, respectively. The results of this study show that colchicine acts to prevent atrial fibrillation by controlling atrial electrical activity, regulating Ca2+, and reducing the electrical effects of collagen.
I find this study interesting because I learned that colchicine has another use besides treating gout and familial Mediterranean fever. Gout and atrial fibrillation are two very different medical conditions, so it is interesting that some drugs function in ways that can effect many different pathways in the human body. In all honesty, this study was very complicated and difficult for me to interpret. I still don’t understand everything that was tested, but reading over this study was good practice for developing my literature-reviewing skills. I picked out the information that was most relevant to me as a student pharmacist, which was how colchicine physiologically prevents atrial fibrillation. It will be important as a pharmacist to keep up with literature showing alternate uses for medications so we know how to handle our patients that are taking drugs for non-FDA approved uses.
My question posed to colleagues: What are your thoughts about colchicine being used to prevent atrial fibrillation in post-operative patients?