Colchicine Revisited

Abstract

Purified from a Mediterranean plant nearly two centuries ago, colchicine has been discovered to inhibit many steps in the inflammatory process. The drug has good oral bioavailability and some enterohepatic recirculation, requiring dose adjustments for kidney disease and avoidance in liver disease. Toxicities are primarily gastrointestinal, hepatic, and hematologic. Colchicine is approved by the U.S. Federal Drug Administration for the treatment and prophylaxis of gout flares but has also been tried with varying success in the treatment of familial Mediterranean fever, primary biliary cirrhosis, psoriasis, Behçet's disease, aphthous stomatitis, linear IgA dermatosis, relapsing polychondritis, Sweet's syndrome, scleroderma, amyloidosis, leukocytoclastic vasculitis, epidermolysis bullosa, and dermatomyositis.

Gout as autoinflammatory disease: New mechanisms for more appropriated treatment targets

“…It is able to reduce neutrophil activity and migration by blocking microtubule assembly, phagocytosis and transport of MSU crystals, and reducing adhesion molecules on endothelial cells in response to IL-1 or TNF-a [46,74,75]. More recently, it has been demonstrated that colchicine also reduces NALP3 inflammasome-driven caspase-1 activation by microtubule inhibition which decreases MSU delivery [76].…”

Effect of colchicine on experimental acetic acid induced colitis

“…However colchicine can enter all tissues, it is lipophilic and quickly absorbed in the jejenum and ileum. Peak in plasma levels is obtained about two hours after oral administration [24,25]. In our study oral or intraperitoneal colchicine therapy did not provide any marked improvement on macroscopic and microscopic scores.…”

Colchicine in Renal Medicine: New Virtues of an Ancient Friend

“…All authors recommend significant dose reductions in patients with glomerular filtration rate (GFR) <50 mL/min/1.73 m 2 . Some authors recommend complete avoidance of colchicine in patients with GFR <10 mL/ min/1.73 m 2 and patients undergoing hemodialysis [6,89] . However, these recommendations are not based on firm data.…”