Consensus Statement Regarding the Efficacy and Safety of Long-Term Low-Dose Colchicine in Gout and Cardiovascular Disease

Philip C. Robinson, Robert Terkeltaub, Michael H. Pillinger, Binita Shah, Vangelis Karalis, Eleni Karatza, David Liew, Massimo Imazio, Jan H. Cornel, Peter L. Thompson, Mark Nidorf

Research output: Contribution to journalReview articlepeer-review

14 Citations (Scopus)

Abstract

Over the last decade, evidence has demonstrated that long-term, low-dose colchicine (0.5 mg daily) is effective for preventing gout flare and cardiovascular (CV) events in a wide range of patients. Given the potentially expanding use of colchicine in CV disease, we here review and update the biologic effects and safety of colchicine based on recent data gathered from bench and pharmacodynamic studies, clinical reports, controlled clinical trials, and meta-analyses, integrated with important studies over the last 50 years, to offer a consensus perspective by experts from multiple specialties familiar with colchicine's long-term use. We conclude that the clinical benefits of colchicine in gout and CV disease achieved at low dose do not sustain serum levels above the upper limit of safety when used in patients without advanced renal or liver disease or when used concomitantly with most medications. Further, data accrued over the last 50 years strongly suggest that the biologic effects of long-term colchicine do not increase the risk of cancer, sepsis, cytopenia, or myotoxicity.

Original languageEnglish
Pages (from-to)32-38
Number of pages7
JournalAmerican Journal of Medicine
Volume135
Issue number1
Early online date2021
DOIs
Publication statusPublished - Jan 2022

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