POS1105 EFFICACY AND SAFETY OF COLCHICINE FOR THE TREATMENT OF OSTEOARTHRITIS: A SYSTEMATIC REVIEW AND META-ANALYSIS OF INTERVENTION TRIALS

Abstract

BackgroundColchicine, an approved treatment for gout, has been trialled in many diseases, including osteoarthritis (OA), due to its anti-inflammatory effects. However, its efficacy and safety remain unclear in OA.ObjectivesThis systematic review and meta-analysis evaluated the efficacy and safety of colchicine for the treatment of OA.1MethodsPubMed, Web of Science, Scopus, and Cochrane Central were searched from inception through November 2020. Two reviewers independently screened for randomised controlled trials (RCTs) comparing colchicine with placebo or other active-comparators for the treatment of OA (knee, hand, or hip OA), extracted data, and performed Cochrane risk of bias assessments.ResultsThe search retrieved 391 articles after removing duplicates, and 16 full-text articles were reviewed for eligibility (Figure 1A). Ten RCTs, nine in knee OA, one in hand OA, consisting of 847 patients (429 in colchicine arm, 409 in control arm) were included. RCTs were conducted between 2002 and 2021; three in India, two in Iran and Turkey, and one each in Australia, Singapore, and Iraq; follow-up period ranged 2 to 12 months. Moderate-quality evidence showed no clinically important pain reduction with colchicine compared to placebo in knee/hand OA patients (standardised mean difference [SMD], -0.17; 95% confidence interval [CI], -0.55 to 0.22) (Figure 1B). Moderate-quality evidence showed no improvement in dysfunction with colchicine compared to placebo in knee OA patients (SMD, -0.37; 95% CI, -0.87 to 0.13). Colchicine showed an acceptable safety profile with AEs/SAEs comparable to placebo (Figure 1C)ConclusionCurrent evidence does not conclusively suggest a benefit of colchicine in reducing pain and improving physical function in hand/knee OA patients. Future trials should focus on the sub-groups of OA patients with local or systemic evidence of inflammation and/or mineralisation who may benefit from colchicine.