KOA: colchicine fails to relieve symptoms, inflammation in COLKOA

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Takeaway

  • Colchicine did not succeed in relieving symptoms and inflammation of knee osteoarthritis (KOA) in a 16-week Colchicine effectiveness in symptoms and inflammation modification in knee osteoarthritis (COLKOA) trial.

Why this matters

  • Since the trial showed some improvement in inflammation, its 16-week duration may not have been long enough to succeed.

Study design

  • This was a double-blind, placebo-controlled randomized trial of 0.5 mg twice-daily oral colchicine vs placebo in KOA.
  • The primary outcome was ≥30% improvement in total Western Ontario and McMaster Universities Osteoarthritis Index at week 16.
  • Funding: Duke Collaborative Research Grant; Centre Grants of Singapore General Hospital; National Medical Research Council, Singapore.

Key results

  • Odds of achieving primary response was similar with colchicine vs placebo (38.9% vs 49.1%; P=.284), corresponding to an adjusted OR of 0.58 (P=.184).
  • In the colchicine group, there were nonsignificant reductions in synovial fluid levels of IL-6, IL-8, TNFα, CD14, and IL-18, and lower mean serum high-sensitivity C-reactive protein (P=.008) and synovial fluid C-terminal crosslinked telopeptide of type I collagen (P=.002).

Limitations

  • Small sample size.
  • Lower than expected effect size in the treatment arm.