Prophylactic colchicine therapy of intercritical gout. A placebo‐controlled study of probenecid‐treated patients

Paulus, Harold E.; Schlosstein, Lee; Godfrey, Robert G.; Klinenberg, James R.; Bluestone, Rodney

doi:10.1002/art.1780170517

Cited by 102 publications

(62 citation statements)

References 6 publications

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“…Colchicine is the most widely used drug for flare prophylaxis. Two clinical trials have shown the effectiveness of low-dose colchicine (0.6-1.5 mg daily) in preventing flares and their severity [Borstad et al 2004;Paulus et al 1974]. A common side effect is diarrhoea but at low doses (0.5-0.6 mg daily or every other day), colchicine is generally well tolerated.…”

Section: Prophylaxismentioning

confidence: 99%

Gout: optimizing treatment to achieve a disease cure

Bernal

Quilis

Andrés

et al. 2016

Therapeutic Advances in Chronic Disease

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Gout is one of the most common inflammatory arthritides. The disease is due to the deposition of monosodium urate crystals. These deposits are reversible with proper treatment, suggesting that gout is a curable disease. The main aim in gout is to lower serum uric acid levels to a pre-established target; there are different urate-lowering drugs (xanthine oxidase inhibitors, uricosurics and uricases) through which this can be achieved. Proper treatment of gout also involves correct management of acute flares and their prevention. To ensure treatment adherence it is necessary to explain to the patient what the objectives are.

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Section: Prophylaxismentioning

confidence: 99%

Gout: optimizing treatment to achieve a disease cure

Bernal

Quilis

Andrés

et al. 2016

Therapeutic Advances in Chronic Disease

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“…The 2006 EULAR recommendations highlighted the administration of oral colchine and/or NSAIDs as first line prophylactic treatment for acute attacks. Two controlled clinical studies have evaluated and shown the prophylactic efficacy of colchicine (79,80). A controlled study on patients with gout who have started treatment with allopurinol has compared the efficacy of colchicine (0.6 mg daily) to a placebo and has shown a significant reduction in the number of acute attacks [7/21 vs 17/22, NNT 2 (1-6)] but an increase in adverse gastrointestinal effects (diarrhoea) [RR (95% CI): 8.38 (1.14, 61.38)] during the first three months of therapy with colchicine combined with allopurinol.…”

Section: Strength Of Recommendation (95% Ci): 87 (81 93)mentioning

confidence: 99%

Italian Society of Rheumatology recommendations for the management of gout

et al. 2013

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summary Objective: Gout is the most common arthritis in adults. Despite the availability of valid therapeutic options, the management of patients with gout is still suboptimal. The Italian Society of Rheumatology (SIR) aimed to update, adapt to national contest and disseminate the 2006 EULAR recommendations for the management of gout. Methods: The multidisciplinary group of experts included rheumatologists, general practitioners, internists, geriatricians, nephrologists, cardiologists and evidence-based medicine experts. To maintain consistency with EULAR recommendations, a similar methodology was utilized by the Italian group. The original propositions were translated in Italian and priority research queries were identified through a Delphi consensus approach. A systematic search was conducted for selected queries. Efficacy and safety data on drugs reported in RCTs were combined in a meta-analysis where feasible. The strength of recommendation was measured by utilising the EULAR ordinal and visual analogue scales. Results: The original 12 propositions were translated and adapted to Italian context. Further evidences were collected about the role of diet in the non-pharmacological treatment of gout and the efficacy of oral corticosteroids and low-dose colchicine in the management of acute attacks. Statements concerning uricosuric treatments were withdrawn and replaced with a proposition focused on a new urate lowering agent, febuxostat. A research agenda was developed to identify topics still not adequately investigated concerning the management of gout. Conclusions: The SIR has developed updated recommendations for the management of gout adapted to the Italian healthcare system. Their implementation in clinical practice is expected to improve the management of patients with gout.

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“…Low-dose colchicine (0.5 mg twice daily) however is well tolerated and effective at preventing recurrences 4 particularly after once-off treatments such as intra-articular corticosteroid.…”

Section: Colchicinementioning

confidence: 99%

Management of acute gout

McGill¹

2004

Aust Prescr

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SummaryThe appropriate management of acute gout begins with confirming the diagnosis. When the diagnosis is uncertain consider other possible causes of joint inflammation, particularly sepsis. Anti-inflammatory therapy promptly relieves the pain of acute gout. The rapidity with which anti-inflammatory medication is commenced following the start of an attack is of greater importance than the specific drug chosen or the route of administration. Changes to therapy that aggravate the acute attack, such as altering hypouricaemic medication, should be avoided.

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Prophylactic colchicine therapy of intercritical gout. A placebo‐controlled study of probenecid‐treated patients

Cited by 102 publications

References 6 publications

Gout: optimizing treatment to achieve a disease cure

Gout: optimizing treatment to achieve a disease cure

Italian Society of Rheumatology recommendations for the management of gout

Management of acute gout

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