Update on colchicine, 2017

Abstract

Colchicine is an ancient medication that is currently approved for the treatment of gout and FMF. However, colchicine has a wide range of anti-inflammatory activities, and studies indicate that it may be beneficial in a variety of other conditions. This paper reviews the evidence for the well-established use of colchicine in gout, as well as several other rheumatic diseases. In addition, we highlight the potential benefit of colchicine in cardiac disease, including coronary artery disease in patients both with and without gout.

The anti-viral facet of anti-rheumatic drugs: Lessons from COVID-19

“…One of the oldest know drugs so far in the field of rheumatology is Colchicine. This is an inexpensive, orally administered, potent anti-inflammatory medication that was initially extracted from the autumn crocus and has been used for centuries [189]. Its mechanisms of actions are through the inhibition of tubulin polymerization and microtubule generation and, possibly, effects on cellular adhesion molecules, inflammatory chemokines, and the inflammasome [190,191].…”

Inflammasomes contributing to inflammation in arthritis

“…Colchicine is a widely available, low-cost drug with a range of antiinflammatory properties that has been used in the form of plant extracts as early as 1550 BC to treat joint swelling. 143 Nowadays, colchicine is commonly used for the treatment of two inflammasomopathies: FMF and gout. 144 Moreover, colchicine anti-inflammatory effects have been shown to have potential benefits in other conditions such as Behcet's disease and pericarditis.…”

Management of gout in older people

“…Because the drug is partially cleared by the kidneys (~40–60%), the dose should be reduced if the patient's creatinine clearance is reduced (e.g. <30 mL/min) . Colchicine is also metabolised in the liver by cytochrome P450 3A4/5 and subject to transport from the systemic circulation to the gut via P‐glycoprotein.…”

“…<30 mL/min). 36,37 Colchicine is also metabolised in the liver by cytochrome P450 3A4/5 and subject to transport from the systemic circulation to the gut via P-glycoprotein. These clearance mechanisms put patients on colchicine at risk of serious drug interactions, notably by drugs that inhibit cytochrome P450 3A4/5 and P-glycoprotein, such as clarithromycin and diltiazem.…”