Safety and efficacy of colchicine in crystal-induced arthritis flare in 54 patients with severe chronic kidney disease.

Autor:	Bausson J; Service de Pharmacie-Stérilisation, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Keller N; Service de Néphrologie, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Von Hunolstein JJ; Service de Cardiologie, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Sacrez M; Service de Pharmacie-Stérilisation, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Michel B; Service de Pharmacie-Stérilisation, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Gourieux B; Service de Pharmacie-Stérilisation, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Fourtage M; Service de Pharmacie-Stérilisation, Hôpitaux universitaires de Strasbourg, Strasbourg, France., Felten R; Service de Rhumatologie de Hautepierre, RESO, Centre de Référence des Maladies Autoimmunes Systémiques Rares Est Sud-Ouest, Hôpitaux universitaires de Strasbourg, Strasbourg, France renaud.felten@chru-strasbourg.fr.; Centre d'Investigation Clinique, Inserm 1434, Hôpitaux Universitaires de Strasbourg, Strasbourg, France.; Département Universitaire de Pharmacologie, Addictologie, Toxicologie et Thérapeutique (DUPATT), Hôpitaux Universitaires de Strasbourg, Strasbourg, France.
Jazyk:	angličtina
Zdroj:	RMD open [RMD Open] 2024 Jan 31; Vol. 10 (1). Date of Electronic Publication: 2024 Jan 31.
DOI:	10.1136/rmdopen-2023-003872
Abstrakt:	Introduction: Colchicine, commonly used in gout flare, is contraindicated in severe chronic kidney disease (CKD) (estimated glomerular filtration rate <30 mL/min). However, in this context, there are few alternatives, and colchicine use persists. We evaluated the tolerance of colchicine and its efficacy in patients with severe CKD. Patients and Methods: All prescriptions of colchicine for managing crystal-induced arthritis flare (gout or calcium pyrophosphate deposition (CPPD) disease) in a hospitalised patient with severe CKD were screened from September 2020 to September 2021. After patient consent and treatment information, clinical and biological safety and efficacy data were prospectively collected from day 1 (D1) to D11. Results: We included 54 patients (median age 75 years (IQR 67-83)) with 62 colchicine prescriptions (cases). Twelve (22%) patients were on dialysis. The main reason for hospitalisation was heart failure (31.5%), acute renal failure (22.2%), infection (18.5%) or an acute joint episode (9.3%). In total, 59.3% of patients had diabetes. The prescriptions concerned 58 cases of gout flares, 1 case of CPPD and 3 cases of both. Initial colchicine dosages were ≤0.5 mg/day in 47/62 (75.8%) cases; no dosage exceeded 1 mg/day (median duration of 6 days (IQR 3-11)). Colchicine was well tolerated in 47/61 (77%) cases. No serious adverse event was reported. Colchicine was considered completely effective by the medical team in 48/58 (83%) of cases. Conclusion: The use of colchicine, at reduced doses, was mostly effective to treat crystal-induced arthritis flare in 54 patients with severe CKD and was well tolerated, without any serious adverse events. Competing Interests: Competing interests: None declared. (© Author(s) (or their employer(s)) 2024. Re-use permitted under CC BY-NC. No commercial re-use. See rights and permissions. Published by BMJ.)
Databáze:	MEDLINE
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