Document Detail


Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.
MedLine Citation:
PMID:  15570646     Owner:  NLM     Status:  MEDLINE    
Abstract/OtherAbstract:
OBJECTIVE: The use of colchicine to prevent acute gout flares during initiation of allopurinol therapy is widely practiced despite lack of proven benefit. We investigated if colchicine administration during initiation of allopurinol for chronic gouty arthritis reduces the frequency and/or severity of acute gout flares. METHODS: Patients starting allopurinol for crystal-proven chronic gouty arthritis were randomized to receive colchicine 0.6 mg po bid or placebo in a randomized, prospective, double blind, placebo controlled trial. Subjects were followed for evidence of acute gout flares and remained on study drug for 3 months beyond attaining a serum urate concentration < 6.5 mg/dl. Treatment arms were analyzed regarding frequency of flares, likelihood of any flare or multiple flares, severity of flares on the visual analog scale (VAS), and length of flares in days. RESULTS: Forty-three subjects were studied. Subjects treated with colchicine experienced fewer total flares (0.52 vs 2.91, p = 0.008), fewer flares from 0 to 3 months (0.57 vs 1.91, p = 0.022), fewer flares 3-6 months (0 vs 1.05, p = 0.033), less severe flares as reported on VAS (3.64 vs 5.08, p = 0.018), and fewer recurrent gout flares (p = 0.001). Colchicine was well tolerated. CONCLUSION: Colchicine prophylaxis during initiation of allopurinol for chronic gouty arthritis reduces the frequency and severity of acute flares, and reduces the likelihood of recurrent flares. Treating patients with colchicine during initiation of allopurinol therapy for 6 months is supported by our data.
Authors:
Gregory C Borstad; Leslie R Bryant; Michael P Abel; Daren A Scroggie; Mark D Harris; Jeff A Alloway
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Publication Detail:
Type:  Clinical Trial; Comparative Study; Journal Article; Randomized Controlled Trial; Research Support, U.S. Gov't, Non-P.H.S.    
Journal Detail:
Title:  The Journal of rheumatology     Volume:  31     ISSN:  0315-162X     ISO Abbreviation:  J. Rheumatol.     Publication Date:  2004 Dec 
Date Detail:
Created Date:  2004-11-30     Completed Date:  2005-03-10     Revised Date:  2006-11-15    
Medline Journal Info:
Nlm Unique ID:  7501984     Medline TA:  J Rheumatol     Country:  Canada    
Other Details:
Languages:  eng     Pagination:  2429-32     Citation Subset:  IM    
Affiliation:
Department of Rheumatology, Wilford Hall US Air Force Medical Center, Lackland AFB, San Antonio, Texas, USA.
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MeSH Terms
Descriptor/Qualifier:
Arthritis, Gouty / diagnosis,  drug therapy*
Chronic Disease
Colchicine / administration & dosage*
Dose-Response Relationship, Drug
Double-Blind Method
Drug Administration Schedule
Female
Follow-Up Studies
Humans
Male
Middle Aged
Probability
Prospective Studies
Recurrence / prevention & control
Risk Assessment
Severity of Illness Index
Statistics, Nonparametric
Treatment Outcome
Chemical
Reg. No./Substance:
64-86-8/Colchicine

From MEDLINE®/PubMed®, a database of the U.S. National Library of Medicine


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