Colchicine twice a day for hand osteoarthritis (COLOR): a double-blind, randomised, placebo-controlled trial.


Journal

The Lancet. Rheumatology
ISSN: 2665-9913
Titre abrégé: Lancet Rheumatol
Pays: England
ID NLM: 101765308

Informations de publication

Date de publication:
May 2023
Historique:
received: 21 12 2022
revised: 21 02 2023
accepted: 21 02 2023
medline: 22 1 2024
pubmed: 22 1 2024
entrez: 22 1 2024
Statut: ppublish

Résumé

Colchicine has been suggested for osteoarthritis treatment, but evidence is contradictory. We aimed to investigate colchicine's efficacy and safety compared with placebo in people with hand osteoarthritis. In this single-centre, double-blind, randomised, placebo-controlled trial we recruited adults with symptomatic hand osteoarthritis and finger pain of at least 40 mm on a 100 mm visual analogue scale from an outpatient clinic in Denmark. The hand with the most severe finger pain at inclusion was the target hand. Participants were randomly assigned (1:1) to 0·5 mg colchicine or placebo taken orally twice a day for 12 weeks, stratified by BMI (≥30 kg/m Between Jan 15, 2021, and March 3, 2022, 186 people were screened for eligibility, and 100 were randomly assigned to receive colchicine (n=50) or placebo (n=50). Participants had a mean age of 70·9 (SD 7·5) years, 69 (69%) of 100 were women and 31 (31%) were men. All participants completed the study. The mean change from baseline to week 12 in finger pain were -13·9 mm (SE 2·8) in the colchicine group and -13·5 mm (2·8) in the placebo group, with a between-group difference (colchicine vs placebo) of -0·4 mm (95% CI -7·6 to 6·7; p=0·90). In the colchicine group, there were 76 adverse events in 36 (72%) of 50 participants and one serious adverse advent (migraine attack leading to hospital admission). In the placebo group, there were 42 adverse events in 22 (44%) of 50 participants and two serious adverse events (cholecystitis and elevated alanine aminotransferase concentrations, in the same patient). In people with painful hand osteoarthritis, treatment with 0·5 mg of colchicine twice day for 12 weeks did not effectively relieve pain, and treatment with colchicine was associated with more adverse events. The Oak Foundation, IMK Almene Fond, Minister Erna Hamilton's Scholarship for Science and Art, AP Moller and Wife Chastine McKinney Moller's Foundation for Medical Science Advancement, The Danish Medical Association, the Velux Foundation, Aase and Ejnar Danielsen's Foundation, and Director Emil C Hertz and Wife Inger Hertz's foundation.

Sections du résumé

BACKGROUND BACKGROUND
Colchicine has been suggested for osteoarthritis treatment, but evidence is contradictory. We aimed to investigate colchicine's efficacy and safety compared with placebo in people with hand osteoarthritis.
METHODS METHODS
In this single-centre, double-blind, randomised, placebo-controlled trial we recruited adults with symptomatic hand osteoarthritis and finger pain of at least 40 mm on a 100 mm visual analogue scale from an outpatient clinic in Denmark. The hand with the most severe finger pain at inclusion was the target hand. Participants were randomly assigned (1:1) to 0·5 mg colchicine or placebo taken orally twice a day for 12 weeks, stratified by BMI (≥30 kg/m
FINDINGS RESULTS
Between Jan 15, 2021, and March 3, 2022, 186 people were screened for eligibility, and 100 were randomly assigned to receive colchicine (n=50) or placebo (n=50). Participants had a mean age of 70·9 (SD 7·5) years, 69 (69%) of 100 were women and 31 (31%) were men. All participants completed the study. The mean change from baseline to week 12 in finger pain were -13·9 mm (SE 2·8) in the colchicine group and -13·5 mm (2·8) in the placebo group, with a between-group difference (colchicine vs placebo) of -0·4 mm (95% CI -7·6 to 6·7; p=0·90). In the colchicine group, there were 76 adverse events in 36 (72%) of 50 participants and one serious adverse advent (migraine attack leading to hospital admission). In the placebo group, there were 42 adverse events in 22 (44%) of 50 participants and two serious adverse events (cholecystitis and elevated alanine aminotransferase concentrations, in the same patient).
INTERPRETATION CONCLUSIONS
In people with painful hand osteoarthritis, treatment with 0·5 mg of colchicine twice day for 12 weeks did not effectively relieve pain, and treatment with colchicine was associated with more adverse events.
FUNDING BACKGROUND
The Oak Foundation, IMK Almene Fond, Minister Erna Hamilton's Scholarship for Science and Art, AP Moller and Wife Chastine McKinney Moller's Foundation for Medical Science Advancement, The Danish Medical Association, the Velux Foundation, Aase and Ejnar Danielsen's Foundation, and Director Emil C Hertz and Wife Inger Hertz's foundation.

Identifiants

pubmed: 38251589
pii: S2665-9913(23)00065-6
doi: 10.1016/S2665-9913(23)00065-6
pii:
doi:

Banques de données

ClinicalTrials.gov
['NCT04601883']

Types de publication

Journal Article

Langues

eng

Sous-ensembles de citation

IM

Pagination

e254-e262

Informations de copyright

Copyright © 2023 Elsevier Ltd. All rights reserved.

Déclaration de conflit d'intérêts

Declaration of interests The Parker Institute is supported by a core grant from the Oak Foundation (OCAY-18–774-OFIL). AD has received grants to this project from IMK Almene Fond, Erna Hamilton's Foundation (Minister Erna Hamilton's Scholarship for Science and Art), the AP Møller Foundation (AP Møller and wife Chastine McKinney Møller's Foundation for Medical Science Advancement), The Danish Medical Association, the Velux Foundation, Aase and Ejnar Danielsen's Foundation and Director Emil C Hertz and wife Inger Hertz's foundation. FB has received consulting fees from Horizon Therapeutics. FCM has received grants from Innovation Fund Denmark; and payment or honoraria from Varian and Siemens Healthineers. IKH has received grants from Pfizer and Lily; and payment or honoraria from Novartis and GSK. LT has received payment or honoraria from Eli Lilly, Novartis, and Janssen; and is on the advisory board for Bristol Meyers Squibb and Janssen. MH is on the European Advisory Board for Thuasne Group. MK has received grants from the Innovative Medicines Initiative (APPROACH project) and Dutch Arthritis Society; royalties or licenses from Wolters Kluwer and Springer Verlag; consulting fees for Abbvie, Pfizer, Kiniksa, Flexion, Galapagos, Centre for Human Drug Research, Novartis, and UCB; payment or honoraria from Galapagos and Jansen; and is a member of the Osteoarthritis Research Society International board, a member of the European Alliance of Associations for Rheumatology (EULAR) council and President for the Dutch Society for Rheumatology. PGC has received consulting fees from AbbVie, AstraZeneca, Eli Lilly, Galapagos, GlaxoSmithKline, Grunenthal, Janssen, Levicept, Merck, Novartis, Pfizer, Regeneron, Stryker, and UCB; payment or honoraria from AbbVie; and support from AbbVie to congress attendance. LKS has received grants from the Health Reserach Council of New Zealand amd consulting fees from Pharmac. GMM has received support for attending meeting from Janssen; and is president for the Irish Society of Rheumatology. All other authors declare no competing interests.

Auteurs

Anna Døssing (A)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark. Electronic address: anna.dossing@gmail.com.

Marius Henriksen (M)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Karen Ellegaard (K)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Sabrina Mai Nielsen (SM)

Section for Biostatistics and Evidence-Based Research, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark.

Lisa K Stamp (LK)

Department of Medicine, University of Otago, Christchurch, Christchurch, New Zealand.

Felix C Müller (FC)

Department of Radiology, Herlev and Gentofte Hospital, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Margreet Kloppenburg (M)

Departments of Rheumatology and Clinical Epidemiology, Leiden University Medical Center, Leiden, The Netherlands.

Ida K Haugen (IK)

Center for Treatment of Rheumatic and Musculoskeletal Diseases (REMEDY), Diakonhjemmet Hospital, Oslo, Norway.

Geraldine M McCarthy (GM)

School of Medicine and Medical Science, University College Dublin, Ireland.

Philip G Conaghan (PG)

Leeds Institute of Rheumatic and Musculoskeletal Medicine, University of Leeds and National Institute for Health and Care Research Leeds Biomedical Research Centre, Leeds, UK.

Louise Ulff-Møller Dahl (L)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Lene Terslev (L)

Center for Rheumatology and Spine Diseases, Rigshospitalet, University of Copenhagen, Copenhagen, Denmark.

Roy D Altman (RD)

Division of Rheumatology and Immunology, The David Geffen School of Medicines at the University of California at Los Angeles (UCLA), Los Angeles, CA, USA.

Fabio Becce (F)

Department of Diagnostic and Interventional Radiology, Lausanne University Hospital and University of Lausanne, Lausanne, Switzerland.

Elisabeth Ginnerup-Nielsen (E)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Lene Jensen (L)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Mikael Boesen (M)

Department of Radiology, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Robin Christensen (R)

Section for Biostatistics and Evidence-Based Research, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark; Research Unit of Rheumatology, Department of Clinical Research, University of Southern Denmark, Odense University Hospital, Denmark.

Ulla Dal (U)

Patient Research Partner.

Henning Bliddal (H)

The Parker Institute, Bispebjerg and Frederiksberg Hospital, University of Copenhagen, Frederiksberg, Denmark.

Classifications MeSH