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Review Article – Meta-analysis
Colchicine treatment in adult patients with knee osteoarthritis: Systematic review of the literature
Revisión sistemática de la literatura sobre el tratamiento con colchicina en pacientes adultos con osteoartritis de rodilla
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Mauricio Restrepo-Escobara,b,
Corresponding author
mauricio.restrepoe@udea.edu.com

Corresponding author.
, Manuel de Jesús Carmona-Franceschia, Jorge Hernando Donado Gómeza,c
a Facultad de Medicina, Universidad de Antioquia, Medellín, Colombia
b Sección de Reumatología, Hospital Pablo Tobón Uribe, Medellín, Colombia
c Unidad de Investigaciones y Docencia, Hospital Pablo Tobón Uribe, Medellín, Colombia
This item has received
Received 23 August 2016. Accepted 16 January 2017
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Table 1. Characteristics of the studies included in the review.
Table 2. Risk of bias in each study.
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Abstract
Background

Colchicine is often used in patients with osteoarthritis in which calcium pyrophosphate crystal deposition disease is suspected. Colchicine has also been used by many rheumatologists in clinical practice, and in some trials, on patients with primary osteoarthritis (apparently unrelated to calcium pyrophosphate). However, its role in the treatment of primary osteoarthritis is not clear, and international guidelines have not established recommendations.

Objective

To evaluate the efficacy and safety of colchicine for the treatment of adult patients with primary knee osteoarthritis as well as the form associated with calcium pyrophosphate.

Methods

A structured literature search was conducted using the PubMed, Embase, Cochrane Controlled Trials Register, and LILACS databases. Randomized controlled trials were included in which colchicine was used as intervention in patients with primary or pyrophosphate calcium-associated knee osteoarthritis.

Results

The study included 5 randomized controlled trials, all of which showed a common trend in all estimated points of the joint, favoring the use of colchicine for improvement in pain and functionality. Although the effect was not statistically significant in individual studies, there was a greater tendency of gastrointestinal adverse effects with the use of colchicine. None of the studies assessed quality of life.

Conclusions

Colchicine appears to be an effective and safe alternative for treatment of adult patients with knee osteoarthritis, either primary or associated with the deposit of calcium pyrophosphate crystals. Its use reduces pain and improves functionality, but it can cause gastrointestinal symptoms in some patients.

Keywords:
Osteoarthritis
Osteoarthritis knee
Calcium pyrophosphate
Chondrocalcinosis
Colchicine
Review
Systematic review
Resumen
Contexto

En la práctica clínica de muchos reumatólogos y en algunos ensayos clínicos se ha usado colchicina en pacientes con osteoartritis primaria. A pesar de ello, su papel en el tratamiento de la misma no está claro y las guías no establecen recomendaciones al respecto.

Objetivos

Evaluar la eficacia y la seguridad del tratamiento con colchicina en pacientes adultos con osteoartritis de rodilla, tanto primaria como asociada al depósito de cristales de pirofosfato cálcico.

Métodos

Se llevó a cabo una búsqueda estructurada de la literatura utilizando las bases de datos Pubmed, Embase, Cochrane Controlled Trials Register y LILACS. Se incluyeron ensayos clínicos controlados, aleatorizados, en donde se haya usado colchicina como intervención en pacientes adultos con osteoartritis de rodilla, primaria o relacionada con pirofosfato de calcio.

Resultados

Se incluyeron 5 ensayos clínicos controlados. Se observó una tendencia común en todos los estimados puntuales de los artículos a favorecer el uso de la colchicina para la mejoría del dolor y de la funcionalidad. Se observó una mayor tendencia de efectos adversos gastrointestinales con el uso de la colchicina, sin embargo, el efecto no fue estadísticamente significativo en los estudios individuales. Ninguno de los estudios evaluó calidad de vida.

Conclusiones

La colchicina parece ser una alternativa eficaz y segura para el tratamiento de pacientes adultos con osteoartritis de rodilla, tanto primaria como asociada al depósito de cristales de pirofosfato de calcio. Su uso reduce el dolor y mejora la funcionalidad, aunque puede producir síntomas gastrointestinales en algunos pacientes.

Palabras clave:
Osteoartritis
Osteoartritis de la rodilla
Pirofosfato de calcio
Condrocalcinosis
Colchicina
Revisión
Revisión sistemática

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