Efficacy and safety of long-term administration of various doses of colchicine in patients with gout

The aim – to compare the efficacy and safety of different doses of colchicine (0.5 mg/day vs 1.0 mg/day) used for the prevention of arthritis attacks in gout patients during the initiation of urate-lowering therapy.

Materials and methods. The study included 96 patients diagnosed with gout. Patients were randomized into three groups: those receiving colchicine 0.5 mg/day, colchicine 1 mg/day, and those without anti-inflammatory therapy. All participants were prescribed febuxostat 80 mg/day. The duration of the observation period was 6 months. The frequency and severity of arthritis attacks, as well as the incidence of adverse events, were compared.

Results. Patients who did not receive colchicine experienced arthritis attacks more frequently compared to those receiving 0.5 mg/day (p=0.03) and 1 mg/day (p=0.007). In the groups receiving colchicine 0.5 mg/day and 1.0 mg/day, the frequency of attacks did not differ significantly (p=0.6), nor did the proportion of patients who did not experience arthritis attacks – 18 (56%) and 22 (69%), respectively (p=0.3). Among patients not taking colchicine, 9 (28%) did not develop arthritis attacks (p=0.02 compared to those taking 0.5 mg/day and p=0.001 for 1 mg/day). The administration of colchicine 1 mg/day (but not 0,5 mg/day) was associated with lower pain intensity on the visual analog scale during arthritis attacks compared to the non-therapy group (p=0.04). The frequency of adverse events was comparable across the groups.

Conclusion. The use of colchicine 0.5 mg/day for the prevention of arthritis attacks in gout patients is justified due to the absence of differences in efficacy compared to the higher dose. However, prescribing colchicine 1 mg/day also demonstrates a good safety profile and may be considered for the prevention of arthritis attacks.

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