title: Risk of Colchicine-Associated Myopathy in Gout: Influence of Concomitant Use of Statin.
abstract: OBJECTIVE
  The purpose of this study was to investigate the risk of myopathy when statins are coadministered with colchicine in patients with gout.
  
  
  METHODS
  In gout patients who received colchicine with or without statin, clinical data collected included medications and history of hypertension, chronic kidney disease, and liver cirrhosis. Myopathy was defined as the presence of muscle symptoms with elevated creatine kinase or myoglobin. Multivariate analysis was performed to identify risk factors for myopathy. Inverse probability of treatment weighting (IPTW)-adjusted analysis was used to evaluate the influence of concomitant colchicine and statin use on myopathy.
  
  
  RESULTS
  Of 674 patients, 486 received colchicine alone and 188 also received statin. The incidence of myopathy was not significantly higher in those on both drugs than in those on colchicine alone (2.7% vs 1.4%, P = .330). On multivariate analysis, chronic kidney disease (hazard ratio [HR] 29.056; 95% confidence interval [CI], 4.387-192.450; P <.001), liver cirrhosis (HR 10.676; 95% CI, 1.279-89.126; P = .029), higher colchicine dose (HR 20.960; 95% CI, 1.835-239.481; P = .014), and concomitant CYP3A4 inhibitor (HR 12.027; 95% CI, 2.743-52.725; P = .001) were associated with increased risk of myopathy. Concomitant use of statins, however, was not, even after adjusting for confounders (HR 1.123; 95% CI, 0.262-4.814; P = .875; IPTW-adjusted HR 0.321; 95% CI, 0.077-1.345; P = .120).
  
  
  CONCLUSIONS
  Concomitant use of statin and colchicine was not associated with increased risk of myopathy. Thus, concomitant use of statin with colchicine seems to be safe from myotoxicity in gout patients.
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Oh Chan
authors.initials: OC
authors.lastname: Kwon
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea. Electronic address: medivineluke@gmail.com.
authors.forename: Seokchan
authors.initials: S
authors.lastname: Hong
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Byeongzu
authors.initials: B
authors.lastname: Ghang
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Yong-Gil
authors.initials: YG
authors.lastname: Kim
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Chang-Keun
authors.initials: CK
authors.lastname: Lee
authors.affiliation: Division of Rheumatology, Department of Medicine, University of Ulsan, College of Medicine, Asan Medical Center, Seoul, Korea.
authors.forename: Bin
authors.initials: B
authors.lastname: Yoo
mesh_terms: D003078:Colchicine / Q000009:adverse effects* / Q000627:therapeutic use; D051544:Cytochrome P-450 CYP3A / Q000627:therapeutic use; D004334:Drug Administration Schedule; D005260:Female; D006073:Gout / Q000150:complications / Q000188:drug therapy*; D006074:Gout Suppressants / Q000009:adverse effects* / Q000627:therapeutic use; D006801:Humans; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors / Q000009:adverse effects* / Q000627:therapeutic use; D008103:Liver Cirrhosis / Q000150:complications; D008297:Male; D008875:Middle Aged; D009135:Muscular Diseases / Q000139:chemically induced*; D051436:Renal Insufficiency, Chronic / Q000150:complications; D012307:Risk Factors
chemical_list: D006074:Gout Suppressants; D019161:Hydroxymethylglutaryl-CoA Reductase Inhibitors; D051544:Cytochrome P-450 CYP3A; D003078:Colchicine
keywords: Colchicine; Gout; Myopathy; Statin