title: A double-blind randomized controlled trial appraising the symptom-modifying effects of colchicine on osteoarthritis of the knee.
abstract: OBJECTIVE
  Osteoarthritis (OA) is the most common articular disease. Common OA treatments are either not effective or associated with side effects. Calcium-containing crystals are quite common in primary OA and they worsen or may cause OA through induction of inflammation by neutrophils. Colchicine inhibits urate-crystal and calcium-pyrophosphate (CPP) crystal induced inflammation and elastase, a matrix-metalloproteinase (MMP) that play a pivotal role in degenerative joint processes. Hence, it was hypothesized that it may have symptom-modifying effects on OA.
  
  
  METHODS
  Sixty-one postmenopausal patients with primary knee OA were enrolled. None of them had joint involvement atypical for OA or evidences of chondrocalcinosis in radiographic studies suggesting the presence of calcium-pyrophosphatedeposition-disease (CPPD). Participants were allocated to two groups receiving 0.5mg colchicines BID or placebo. Both groups received common OA treatments. Acetaminophen less than 2gr/day was used as rescue-analgesic. The efficacy end points were: patients' global assessment and physician's global assessment, recorded on a VAS (visual analogue scale). Statistical analysis was performed 3 months later.
  
  
  RESULTS
  Thirty-one patients were assigned to the colchicine group. Fifty-eight patients were present for the last survey. Only 1 patient in colchicine group encountered adverse effect of colchicine without significant difference between the two groups. Acetaminophen consumption was significantly less in the colchicine (879.3±369.7) compared to placebo group (1620.7±393.1, p=0.000). Improvement rate at the end of 3 months was significantly higher in the colchicine group for both patients' global assessment and physician's global assessment measures compared to placebo group, (11.14±4.06 vs. 3.14±2.18, p=0.000) and (9.83±3.799 vs. 3.72±3.35, p=0.000), respectively.
  
  
  CONCLUSIONS
  The efficacy and safety of colchicine for pain reduction in OA was affirmed by our double-blind randomised controlled trial.
authors.affiliation: Center for Advanced Orthopaedic Studies, harvard Medical School, Boston, MA 02215, USA. saran@bidmc.harvard.edu
authors.forename: S
authors.initials: S
authors.lastname: Aran
authors.forename: S
authors.initials: S
authors.lastname: Malekzadeh
authors.forename: S
authors.initials: S
authors.lastname: Seifirad
mesh_terms: D000082:Acetaminophen / Q000627:therapeutic use; D000368:Aged; D018712:Analgesics, Non-Narcotic / Q000627:therapeutic use; D018771:Arthralgia / Q000188:drug therapy; D002805:Chondrocalcinosis / Q000150:complications / Q000000981:diagnostic imaging; D003078:Colchicine / Q000009:adverse effects* / Q000627:therapeutic use*; D004305:Dose-Response Relationship, Drug; D004311:Double-Blind Method; D005260:Female; D006074:Gout Suppressants / Q000009:adverse effects* / Q000627:therapeutic use*; D006801:Humans; D008875:Middle Aged; D020370:Osteoarthritis, Knee / Q000000981:diagnostic imaging / Q000188:drug therapy* / Q000209:etiology; D010147:Pain Measurement; D011859:Radiography; D016896:Treatment Outcome
chemical_list: D018712:Analgesics, Non-Narcotic; D006074:Gout Suppressants; D000082:Acetaminophen; D003078:Colchicine