title: GOSPEL 2 - Colchicine for the treatment of gout flares in France - a GOSPEL survey subgroup analysis. Doses used in common practices regardless of renal impairment and age.
abstract: OBJECTIVE
  The objective of this sub-study was to assess the use of colchicine for the treatment of gout flares in real life conditions in the GOSPEL cohort following the 2006 EULAR recommendations for gout management.
  
  
  METHODS
  This national cross-sectional epidemiologic survey included outpatients with gout suffering from acute flare followed by randomly selected primary care physicians (n=398) and private practice rheumatologists (n=109) between October 2008 and September 2009 in France. Data regarding patient characteristics and treatment prescription was collected by each physician. Glomerular filtration rate (eGFR) was estimated using the Cockroft-Gault formula. Patients included in the survey for a gout flare filled in a specific self-questionnaire including colchicine effective intake and pain relief (numeric scale).
  
  
  RESULTS
  This analysis focused on the 349 patients presenting with gout flare and treated with colchicine. Mean (±SD) prescribed dose of colchicine was 2.8 (±0.7) mg within the first 24hours and the cumulative dose over the first three days of treatment was 6.9 (±1.8) mg. Patients with mild decline in eGFR (eDFG 60-80mL/min) were prescribed an average initial dose of 2.8mg (±0.8) mg (n=58), 2.7 (±0.8) mg in chronic kidney disease (CKD) stage 3 (n=43) and 2.5 (±0.7) mg in CKD stage 4 (n=2). Cumulative doses of colchicine did not take into account either renal impairment or age.
  
  
  CONCLUSIONS
  This study draws attention to some misuse of colchicine in daily practice and the prescription of excessive doses especially in case of renal impairment. eGFR should be enforced in daily practice.
authors.affiliation: Service de rhumatologie, université catholique de Lille, hôpital Saint-Philibert, 59160 Saint-Philibert, France; Service de rhumatologie, université Lille 2, hôpital Roger-Salengro, 59037 Lille, France.
authors.forename: Tristan
authors.initials: T
authors.lastname: Pascart
authors.affiliation: Sylia-Stat, 92340 Bourg-La-Reine, France.
authors.forename: Sylvie
authors.initials: S
authors.lastname: Lancrenon
authors.affiliation: Laboratoires Mayoly-Spindler, 78400 Chatou, France.
authors.forename: Sabine
authors.initials: S
authors.lastname: Lanz
authors.affiliation: Sylia-Stat, 92340 Bourg-La-Reine, France.
authors.forename: Catherine
authors.initials: C
authors.lastname: Delva
authors.affiliation: Service de rhumatologie, CHU de Rennes, 35000 Rennes, France; Inserm UMR 991, 35000 Rennes, France; Université de Rennes 1, 35000 Rennes, France.
authors.forename: Pascal
authors.initials: P
authors.lastname: Guggenbuhl
authors.affiliation: Laboratoires Ipsen Pharma, 92100 Boulogne, France.
authors.forename: Charles
authors.initials: C
authors.lastname: Lambert
authors.affiliation: Université Paris-Diderot, Sorbonne Paris-Cité, EA recherche clinique coordonnée ville-hôpital, méthodologies et société (REMES), 75018 Paris, France.
authors.forename: Jean-Pierre
authors.initials: JP
authors.lastname: Aubert
authors.affiliation: Service de rhumatologie, université de Bretagne Occidentale, CHU de la Cavale-Blanche, 29200 Brest, France.
authors.forename: Alain
authors.initials: A
authors.lastname: Saraux
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75205 Paris, France; Pôle appareil locomoteur, service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm, UMR 1132, hôpital Lariboisière, 75010 Paris, France.
authors.forename: Hang-Korng
authors.initials: HK
authors.lastname: Ea
authors.affiliation: Université Paris Diderot, Sorbonne Paris Cité, 75205 Paris, France; Pôle appareil locomoteur, service de rhumatologie, centre Viggo-Petersen, hôpital Lariboisière, AP-HP, 2, rue Ambroise-Paré, 75010 Paris, France; Inserm, UMR 1132, hôpital Lariboisière, 75010 Paris, France. Electronic address: frederic.liote@lrb.aphp.fr.
authors.forename: Frédéric
authors.initials: F
authors.lastname: Lioté
mesh_terms: D000367:Age Factors; D000368:Aged; D003078:Colchicine / Q000008:administration & dosage* / Q000009:adverse effects*; D003430:Cross-Sectional Studies; D019468:Disease Management; D018450:Disease Progression; D004305:Dose-Response Relationship, Drug; D004334:Drug Administration Schedule; D005260:Female; D005500:Follow-Up Studies; D005602:France; D005919:Glomerular Filtration Rate / Q000187:drug effects; D006073:Gout / Q000175:diagnosis* / Q000188:drug therapy*; D006074:Gout Suppressants / Q000008:administration & dosage / Q000009:adverse effects; D006801:Humans; D007677:Kidney Function Tests; D008297:Male; D020714:Maximum Tolerated Dose; D008875:Middle Aged; D061214:Patient Safety; D017410:Practice Guidelines as Topic; D010818:Practice Patterns, Physicians'; D018570:Risk Assessment; D012720:Severity of Illness Index; D016896:Treatment Outcome
chemical_list: D006074:Gout Suppressants; D003078:Colchicine
keywords: Ageing; Chronic kidney disease; Colchicine; Drug dosage; Gout; Management