A systematic review of low-dose and routine-dose colchicine regimen in the treatment of acute gout flare

Abstract

Abstract: AIM : To investigate the efficacy and safety of low-dose colchicine regimen compared with routine-dose colchicines for acute gout flare.METHODS: We searched MEDLINE, Sciencedirect, CNKI and WanFang database systematically. RevMan5 was used for meta-analysis.RESULTS:A total of 11 randomized controlled trials matched our inclusion and exclusion criteria. Meta-analysis found that low-dose colchicine regimen showed no significant difference compared with routine-dose colchicine regimen in the proportion of at least a 2-unit reduction in target joint pain score(RR 1.04, 0.95%CI 0.77-1.40, P=0.81), proportion of pain relief(RR 1.06, 95%CI 0.85-1.31, P=0.62) and proportion of clinical efficacy(RR 0.89, 95% CI 0.71-1.11, P=0.29). In addition, gastrointestinal adverse reaction(RR 0.25, 95% CI 0.19-0.34, P<0.000 01) and overall adverse reaction rate(RR 0.36, 95% CI 0.26-0.50, P<0.000 01) were lower in low-dose colchicine group. Similarly, there was no significant difference concerning clinical efficacy rate(RR 1.46, 95% CI 0.42-5.08, P=0.55)between low-dose colchicines + non-steroid anti-inflammtory drugs group compared with routine-dose colchicine group. However, fewer patients experienced overall adverse reaction(RR 0.16, 95% CI 0.08-0.29, P<0.000 01), withdrawal due to adverse reaction(RR 0.14, 95% CI 0.07-0.28, P<0.00001)and gastrointestinal adverse reaction(RR 0.17, 95% CI 0.11-0.27, P<0.000 01)in low-dose colchicines + non-steroid anti-inflammtory drugs group.CONCLUSION: Our meta-analysis indicated that routine-dose colchicine regimen showed no significant superior to low-dose colchicine regimen, and routine-dose colchicine regimen increased the risk of adverse reaction significantly.

Key words: colchicine, dosage, efficacy, safety, gout

CLC Number:

R311

MENG Long, LI Juan, LONG Rui, JIA Yun-tao. A systematic review of low-dose and routine-dose colchicine regimen in the treatment of acute gout flare[J]. Chinese Journal of Clinical Pharmacology and Therapeutics, 2014, 19(6): 656-662.

References

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