Background Colchicine has been used for millennia to treat acute gout flare, but numerous other conditions have been proposed for the use of this “eau médicinale”, including familial Mediterranean fever, Behçet's disease and pericarditis.
Objectives To investigate the efficacy and safety of colchicine whatever the indication.
Methods A literature search of MEDLINE, EMBASE and Cochrane library databases was performed for human studies without language restriction from inception to January 2016, using the followings key-words: “colchicine”, “clinical trial”, “clinical controlled trials”, “randomized controlled trials”. We did not impose any date or language restrictions in the search. We also handsearched reference lists of identified studies.
Results The process of selection of studies is presented in Figure 1. Of the 477 articles reviewed, 106 were analyzed including 77 randomized controlled trials, 2 nonrandomized controlled trials and 27 open studies. The subjects studied were chronic liver disease (n=13), primary biliary cirrhosis (n=11), post cardiac surgery syndromes (n=11), pericarditis (n=9), coronary syndromes and other heart disease (n=6), Familial Mediterranean fever (n=5), Behçet's disease (n=5), amyloidosis (n=4), gout (n=3), knee osteoarthritis (n=3), constipation (n=3), lung fibrosis (n=3), psoriasis and psoriatic arthritis (n=3), asthma (n=3), primary sclerosing cholangitis (n=2), low back pain (n=2), proliferative vitreoretinopathy (n=2), recurrent aphthous stomatitis (n=2). Other indications have been evaluated in one clinical trial (Graves' ophthalmopathy, oral mucositis during hematological malignancies, Peyronie's disease, hidradinitis suppurativa, acne vulgaris, chronic bullous dermatosis, actinic keratosis, cutaneous leukocytoclastic vasculitis, finger clubbing and hypertrophic osteoarthropathy, pustulosis palmaris and plantaris, scleroderma, penile condylomata acuminate, mixed cryoglobulinemia, allergic rhinitis, delayed urticaria). Table 1 summarizes the main directions of colchicine in clinical trials. The most common adverse events were gastrointestinal intolerance.
Conclusions Although acute gout is the major indication for use of colchicine, only 3 clinical trials are available for gout and no for other crystal-induced arthritis. Evidence are limited for knee osteoarthritis, low back pain and psoriatic arthritis. Clinical trials published are dominated by the treatement of heart diseases (especially pericarditis), systemic diseases (primary biliary cirrhosis, Familial Mediterranean fever, Behçet's disease) and others chronic liver diseases.
Disclosure of Interest None declared