Comparative efficacy of low-dose versus regular-dose colchicine to prevent flares in gout patients initiated on urate-lowering therapies.
To compare the prophylactic effect between regular-dose (RD, 1.2 mg/day) and low-dose (LD, 0.6 mg/day) colchicine on gout flare when initiating urate-lowering therapy (ULT).In this retrospective cohort study, we included gout patients who were initiated on allopurinol or febuxostat and colchicine therapy and followed them up for three 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.Of the total 419 patients with gout, 177 (42.2%) patients received LD colchicine, whereas 242 (57.8%) patients received RD colchicine. Lower body mass index 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%; 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
Authors: Soo Min Ahn, Ji Seon Oh, Seokchan Hong, Chang-Keun Lee, Bin Yoo, Yong-Gil Kim