Affiliation:
1. Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Seoul, Republic of Korea
2. Department of Information Medicine, Big Data Research Center, Asan Medical Center, Seoul, Republic of Korea
Abstract
Abstract
Objective
The objective of this study was to compare the prophylactic effect of regular-dose (RD, 1.2 mg/day) vs low-dose (LD, 0.6 mg/day) colchicine on gout flare when initiating urate-lowering therapy.
Methods
In this retrospective cohort study, we included gout patients who were initiated on either allopurinol or febuxostat, in combination with colchicine therapy and followed them up for 3 months. We analysed the rates of gout flare and adverse events according to the dose of colchicine. We performed the inverse probability of treatment weighting (IPTW) and weighted logistic regression analysis to assess the treatment effect. Analysis of gout flares and adverse events was performed on an intention-to-treat (ITT) and per-protocol (PP) basis.
Results
Of the total of 419 patients with gout, 177 patients (42.2%) received LD colchicine, whereas 242 patients (57.8%) received RD colchicine. Lower BMI and estimated glomerular filtration rate, and higher incidence of cardiovascular disease were seen in the LD group than in the RD group. In IPTW-adjusted analysis, events of gout flare were not significantly different between the LD and RD groups [ITT: 14.3% vs 11.3%; odds ratio (OR): 1.309, 95% CI: 0.668, 2.566, P = 0.432; PP: 15.3% vs 10.0%; OR: 1.623, 95% CI: 0.765, 3.443, P = 0.207]. However, LD colchicine was associated with a lower rate of adverse events than RD colchicine [ITT: 8.2% vs 17.9%; OR: 0.410, 95% CI: 0.217, 0.777; P < 0.05; PP: 8.4% vs 17.2%; OR: 0.442, 95% CI: 0.223, 0.878; P < 0.05].
Conclusion
Our data suggest that LD colchicine can adequately prevent gout flare with fewer adverse events compared with RD colchicine.
Funder
Asan Institute for Life Sciences
Korea Health Industry Development Institute
Ministry of Health & Welfare, Republic of Korea
Publisher
Oxford University Press (OUP)
Subject
Pharmacology (medical),Rheumatology
Reference30 articles.
1. Global epidemiology of gout: prevalence, incidence and risk factors;Kuo;Nat Rev Rheumatol,2015
2. Gout (Primer);Dalbeth;Nat Rev Dis Primers,2019
3. Gout;Neogi;New Engl J Med,2011
4. Rilonacept for gout flare prevention during initiation of uric acid-lowering therapy: results from the PRESURGE-2 international, phase 3, randomized, placebo-controlled trial;Mitha;Rheumatology,2013
5. 2020 American College of Rheumatology Guideline for the Management of Gout;FitzGerald;Arthritis Rheumatol (Hoboken, NJ),2020
Cited by
5 articles.
订阅此论文施引文献
订阅此论文施引文献,注册后可以免费订阅5篇论文的施引文献,订阅后可以查看论文全部施引文献