Colchicine is linked to decreased incidence of total knee and hip replacements in patients with chronic coronary artery disease

An exploratory analysis of the Low-Dose Colchicine 2 (LoDoCo2) study found that a 0.5 mg daily dose of colchicine was associated with a 31% decreased incidence of total knee (TKR) and total hip replacement (THR) in patients with chronic coronary artery disease when compared to placebo.

Heijman and co-researchers conducted an exploratory analysis of the LoDoCo2 study, a randomized controlled trial where participants were randomly assigned to receive either 0.5 mg of colchicine or a placebo daily for over 2 years. A total of 2,762 subjects received colchicine, while 2,760 received a placebo. The incidence rates of TKR and THR were reported as 68 patients (2.5% in the colchicine group) and 97 patients (3.5% in the placebo group), respectively, equating to 0.9 and 1.3 per 100 person-years (hazard ratio = 0.69). Sensitivity analyses excluding TKR and THR incidences within the first 3 months and first 6 months showed similar incidence rates per 100 person-years (0.78 vs. 1.29), as did the exclusion of individuals with baseline gout from the analysis (0.66 vs. 1.14). It is important to note that LoDoCo2 was not specifically designed to investigate the impact of colchicine on knee or hip osteoarthritis, and did not collect specific data related to osteoarthritis.

A meta-analysis conducted in 2022 evaluated five randomized controlled trials involving a total of 400 adult participants with osteoarthritis. When comparing the colchicine group with the placebo group, no significant difference was found in VAS-pain (mean difference -1.49). Furthermore, there was no statistically significant difference observed in the patient report of adverse events (risk difference 1.23) and the Western Ontario and McMaster Universities total index (standardized mean difference -0.13).

Although it is not currently recommended, the findings suggest that colchicine may have a negligible effect in the treatment of knee osteoarthritis. However, it is important to note that the variation in assessment indicators across the available data limits the strength of the conclusion. To further validate these results and provide more conclusive evidence, additional well-designed clinical trials with larger sample sizes and longer follow-up periods are necessary. 

References

  1. Heijman MW, Fiolet AT, Mosterd A, Tijssen JG, van den Bemt BJ, Schut A, Eikelboom JW, Thompson PL, van den Ende CH, Nidorf SM, Popa CD. Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements: Exploratory Analyses From a Randomized, Controlled, Double-Blind Trial. Annals of Internal Medicine. 2023 May 30.
  2. Liu W, Wang H, Su C, Kuang S, Xiong Y, Li Y, Gao S. The evaluation of the efficacy and safety of oral colchicine in the treatment of knee osteoarthritis: a meta-analysis of randomized controlled trails. BioMed Research International. 2022 Jan 29;2022.

 

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