Abstract
Objective To evaluate the efficacy and safety of oral colchicine in the treatment for knee OA. Design Meta-analysis. Data Sources. Embase, PubMed (MEDLINE), the Cochrane Library, and Web of Science from inception to December 12, 2021. Study Selection. RCTs comparing colchicine with placebo for knee OA were included. No language or date restrictions were applied. Two authors abstracted data and determined quality. Outcomes of interest included VAS-pain, WOMAC total index, and patient-reported adverse events. Results A total of five RCTs including 400 adult patients with OA met the inclusion criteria. The mean age of patients included was 56.05 years (range 21 to 79), and 80.87% were female. There was no difference in VAS-pain (MD -1.49; 95% CI -3.15, 0.17; p = 0.08) when compared colchicine group with placebo group. And there was no statistically difference in WOMAC total index (std. MD -0.13; 95% CI -0.64, 0.38; p = 0.61) and patient report adverse events (RR 1.23; 95% CI 0.72, 2.11; p = 0.46). Conclusion Colchicine is not currently recommended as a treatment for knee OA but might have insignificant effect. The conclusion is limited due to the variation in assessment indicator among available data. Further RCTs with larger sample size and longer follow-up are needed to confirm the findings.
Highlights
Osteoarthritis (OA) is a multicausal, chronic disabling disease involving all joints, accompanied by lesions of articular cartilage, subchondral bone, ligaments, synovium, joint capsule, and muscular structures around joints [1]
mean difference (MD) in endpoint of WOMAC total index was -0.13, indicating that there is no statistics difference in drug efficacy evaluated by WOMAC total index between two groups
This is contrary to the recommendation in favor of oral colchicine that can improve pain severity supported by four studies [12, 18,19,20] and physical function supported by other three [12, 18, 20]
Summary
Osteoarthritis (OA) is a multicausal, chronic disabling disease involving all joints, accompanied by lesions of articular cartilage, subchondral bone, ligaments, synovium, joint capsule, and muscular structures around joints [1]. Women have a higher prevalence and greater disability rates than men in this disease [2, 3]. Knee joint is the most common site of OA, and the main causes of knee OA are aging, female sex, previous injury, and obesity [4, 5, 9]. With the aging of the population and the increasing proportion of obese people in current society, we have an unmet need to find effective ways to treat OA [9]
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