Colchicine linked to lower incidence of total knee, hip replacements in patients with chronic coronary artery disease
Compared to placebo, colchicine (0.5 mg once daily) was associated with a 31% lower incidence of total knee replacements and total hip replacements, an exploratory analysis of a randomized controlled trial found.
Colchicine was associated with a lower incidence of total knee replacements and total hip replacements compared with placebo in a recent analysis of a randomized controlled trial.
Researchers conducted an exploratory analysis of the LoDoCo2 (Low-Dose Colchicine 2) randomized controlled trial, which randomized 5,522 patients with chronic coronary artery disease at 43 centers in Australia and the Netherlands to receive colchicine (0.5 mg) or placebo once daily. The analysis examined whether colchicine reduced incident total knee replacements and total hip replacements. The primary outcome was time to first total knee replacement or total hip replacement since randomization, with all analyses performed on an intention-to-treat basis. Results were published May 30 by Annals of Internal Medicine.
During a median follow-up of 28.6 months, 2,762 patients received colchicine and 2,760 received placebo. During the trial, total knee replacement or total hip replacement was performed in 68 patients (2.5%) in the colchicine group and 97 (3.5%) in the placebo group (incidence rate, 0.90 vs. 1.30 per 100 person-years; incidence rate difference, −0.40 [95% CI, −0.74 to −0.06] per 100 person-years; hazard ratio, 0.69 [95% CI, 0.51 to 0.95]). Sensitivity analyses yielded similar results when patients with gout at baseline were excluded and when joint replacements that occurred in the first three and six months of follow-up were omitted.
Since the trial was designed to investigate the effect of colchicine on cardiovascular outcomes, it did not gather data on history of osteoarthritis, joint pain, physical function, radiographic progression, and use of medication for osteoarthritis, the authors noted. They added that the analyses were post hoc and hypothesis-generating and that the absence of information about total knee replacement and total hip replacement before the study makes the primary outcome suboptimal, among other limitations.
The results suggest that “colchicine may slow the progression of osteoarthritis, but this needs to be confirmed in an appropriately designed prospective placebo-controlled trial,” the authors concluded.