MedicalResearch.com Interview with:
Jack A. Yanovski, MD, PhD
Section on Growth and Obesity, DIR, NICHD
National Institutes of Health
Hatfield Clinical Research Center
Bethesda, MD 20892‐1103
MedicalResearch.com: What is the background for this study?
Response: Studies of both mouse models and people suggest that obesity induced inflammation may promote insulin resistance and progression to diabetes. Others have proposed that suppressing this chronic, low level inflammation may slow the onset of diabetes. Nod-like Receptor Family Pyrin Domain Containing 3 (NLRP3) has recently been shown to play a strong role in promoting the inflammatory state in obesity. Colchicine, traditionally used to suppress or prevent inflammation in gout and other disorders is believed to inhibit formation of the NLRP3 inflammasome. Our group hypothesized that colchicine would improve obesity associated inflammation in adults with metabolic syndrome who had not yet developed type 2 diabetes.
MedicalResearch.com: What are the main findings?
Response: Among the 40 participants who were randomized in the trial, colchicine significantly reduced markers of inflammation: C-reactive protein, the erythrocyte sedimentation rate, white blood cell count and absolute neutrophil count, compared to those receiving placebo. The primary outcome, change in insulin sensitivity, did not differ significantly between the colchicine and placebo groups. However, changes in some secondary outcomes that are also measures of how insulin works in the body, including Homeostatic Model Assessment of Insulin Resistance test and fasting insulin, suggested improvements in the colchicine group.
MedicalResearch.com: What should readers take away from your report?
Response: In this pilot study, we found colchicine significantly improved obesity associated inflammation and some metabolic measures as well. This might mean, if these results are confirmed, that colchicine could be a useful medication to help break the link between obesity and its inflammatory consequences.
MedicalResearch.com: What recommendations do you have for future research as a result of this work?
Response: Our results suggest the need for a larger, adequately powered study to determine whether colchicine improves insulin resistance and other measures of metabolic health among individuals at risk of type 2 diabetes.
MedicalResearch.com: Is there anything else you would like to add?
Response: Nothing to add and no disclosures relevant for colchicine.
Disclosures: Dr. Yanovski is Principal Investigator of other studies funded by pharmaceutical companies using medications that are not related to colchicine and not directed at inflammation: Rhythm Pharmaceuticals Inc. (setmelanotide) and Soleno Therapeutics Inc. (diazoxide choline sustained release).
Demidowich, AP, Levine, JA, Onyekaba, GI, et al. Effects of colchicine in adults with metabolic syndrome: A pilot randomized controlled trial. Diabetes Obes Metab. 2019; 1– 10. https://doi.org/10.1111/dom.13702
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