Low dose colchicine associated with lower incidence of total knee and hip replacements

An exploratory analysis of the LoDoCo2 (Low-Dose Colchicine 2) randomized, controlled, double-blind trial found that daily therapy with a low dose of colchicine was associated with lower incidences of both total knee replacement and total hip replacement surgeries. The analysis is published in Annals of Internal Medicine.

Osteoarthritis is an increasingly common joint disease that can be associated with low-grade inflammation in response to weight-bearing traumatic injury. Previous studies have demonstrated an association between the use of anti-inflammatory therapies and the slowing of osteoarthritis disease progression. Colchicine is effective in many inflammatory and fibrotic conditions, but it is not currently recommended for treatment of osteoarthritis. Its long-term effects have also not been assessed.

Researchers from Sint Maartenskliniek and Radboud University Medical Center, Nijmegen, the Netherlands conducted an exploratory analysis of the LoDoCo2 trial to examine whether colchicine, 0.5 mg daily, reduced incident total knee replacements and total hip replacements. In the study, 5,522 participants aged 35 to 82 at 43 centers in Australia and the Netherlands, received 0.5 mg of colchicine daily or matching placebo during a median follow-up of 28.6 months.

The authors found that 2.5 percent of persons receiving colchicine had total knee replacement or total hip replacement compared with 3.5 percent of persons who received placebo. The effects were consistent for men, but there was insufficient statistical power to determine whether these benefits may have extended to women as well. According to the authors, the exploratory observations support the hypothesis that inflammation plays a role in the progression of osteoarthritis.

They also note that colchicine has been widely used in many patients with other diseases and is generally considered to have a favorable safety profile, which makes it a good candidate for treatment of osteoarthritis over longer periods.