A Retrospective Chart Review of the Use of Colchicine for the Treatment of Refractory Chronic Idiopathic Urticaria

Abstract

RATIONALE: Colchicine, a microtubule polymerization inhibitor, may be effective in the treatment of chronic idiopathic urticaria (CIU) because it suppresses mast cell degranulation and leukotriene generation. METHODS: Charts of 55 patients with CIU treated with greater than 7 days of colchicine were reviewed for the following: type of urticaria, type of response, and oral steroid therapy before and after colchicine initiation. The number of steroid courses or the number of exacerbations requiring an increase in baseline steroid dose was tabulated for a minimum of 6 months before and after starting colchicine. Response was defined as subjective improvement and a decrease of at least 50% in oral steroid dose within 3 months of starting colchicine. A partial response was defined as subjective improvement without a decrease in oral steroids by 50% within 3 months of starting colchicine. RESULTS: 24 (44%) patients were responders, 29 (53%) were non-responders, and 2 (4%) were partial-responders. The number of steroid courses before and after colchicine initiation was significantly decreased in the responders (2.44 vs 0.33, P<0.05). Skin biopsies were performed in 27 patients (14 responders, 12 non-responders, 1 partial responder). Skin biopsies showed neutrophilic urticaria in 86% of responders and 25% of non-responders. CONCLUSION: Colchicine is an effective steroid-sparing agent which may be used for the treatment of refractory CIU.