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April 10, 1987, Vol 257, No. 14 >
ARTICLE | April 10, 1987

Colchicine in Acute Gout: Title and subTitle BreakReassessment of Risks and Benefits FREE

W. Neal Roberts, MD; Matthew H. Liang, MD, MPH; Steven H. Stern, MD
[+] Author Affiliations

Reprint requests to Robert B. Brigham Multipurpose Arthritis Center, Brigham and Women's Hospital, 75 Francis St, Boston, MA 02115 (Dr Liang).


JAMA. 1987;257(14):1920-1922. doi:10.1001/jama.1987.03390140090033
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References

Colchicine is an effective and relatively specific treatment for acute gout and has a long, venerable history. Serious toxic reactions to colchicine could be prevented if guidelines for its use were followed strictly, but because of its relatively infrequent use and conflicting recommendations, considerable toxic effects might occur and still be undetected by passive surveillance. A review of a teaching hospital's four years' experience showed two deaths (2% incidence) due to inappropriate use. Colchicine has the smallest benefit-to-toxicity ratio of drugs that are effective for acute gout. This article gives specific recommendations for the use of colchicine in different clinical settings.

(JAMA 1987;257:1920-1922)

REFERENCES

1 +
Gooneratane BWM:  Massive generalized alopecia after poisoning by Gloriosa superba . Br Med J 1966;;1:1023-1024.
2 +
Davis JS, Bartfield H:  The effect of intravenous colchicine on acute gout . Am J Med 1954;;16:218-219.
3 +
Wallace SL, Bernstein D, Diamond H:  Diagnostic value of the colchicine therapeutic trial . JAMA 1967;;199:93-96.
4 +
Spilberg I, Gallacher A, Mehta JM, et al:  Urate crystal-induced chemotactic factor: Isolation and partial characterization . J Clin Invest 1976;;58: 815-819.
5 +
Wallace SL:  Colchicine . Semin Arthritis Rheum 1974;;3:369-381.
6 +
Rodnan GP:  Treatment of the gout and other forms of crystal-induced arthritis . Bull Rheum Dis 1982;;32:77-87.
7 +
Bain LS, Galloway DB, Petrie JC, et al:  Gout . Br Med J 1974;;1:446-448.
8 +
Ferrannini E, Pentimone F:  Marrow aplasia following colchicine treatment for gouty arthritis . Clin Exp Rheum 1984;;2:173-175.
9 +
Stapczynski JS, Rothstein RN, Gaye WA, et al:  Colchicine overdose: Report of two cases and review of the literature . Ann Emerg Med 1981;;10: 364-369.
10 +
Stanley MW, Taurog JD, Snover DC:  Fatal colchicine toxicity: Report of a case . Clin Exp Rheum 1984;;2:167-171.
11 +
Liu YK, Hymowitz R, Carroll MG:  Marrow aplasia induced by colchicine: A case report . Arthritis Rheum 1978;;21:731-735.
12 +
Wallace SL, Omokuku B, Ertel NH:  Colchicine plasma levels: Implications as to pharmacology and mechanism of action . Am J Med 1970;;48:443-448.
13 +
Malawista SE: Colchicine:  A common mechanism for its anti-inflammatory and anti-miotic effects . Arthritis Rheum 1968;;11:191-197.
14 +
Ertel NH, Wallace SL:  Measurement of colchicine in urine and peripheral leukocytes, abstracted . Clin Res 1971;;19:348A.
15 +
Chang RW, Fineberg HV:  Risk-benefit considerations in the management of polymyalgia rheumatica . Med Decis Making 1983;;3:459-475.
16 +
Fox IH, Kelley WN:  Management of gout . JAMA 1979;;242:361-364.
17 +
Freeman DL:  Frequent doses of intravenous colchicine can be lethal . N Engl J Med 1983;; 304:310.
18 +
Varga J:  On colchicine toxicity . Clin Exp Rheum 1984;;2:357.
19 +
Kelley WN, Harris ED, Ruddy S, et al: Textbook of Rheumatology . Philadelphia, WB Saunders Co, 1985;, pp 871-878.
20 +
McCarty DT (ed): Hollander's Arthritis and Allied Conditions . Philadelphia, Lea & Febiger, 1985;, pp 1507-1508.
21 +
Bennett DR (ed): AMA Drug Evaluations , ed 6. Philadelphia, WB Saunders Co, 1986;, pp 1081-1082.
22 +
Rakel RE (ed): Current Therapy . Philadelphia, WB Saunders Co, 1986;, pp 438-439.
23 +
Orland MJ, Saltman RJ (eds): Manual of Therapeutics . Boston, Little Brown & Co, 1986;, p 389.
24 +
Wyngaarden C: Textbook of Medicine . Philadelphia, WB Saunders Co, 1985;, p 1141.

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1 +
Gooneratane BWM:  Massive generalized alopecia after poisoning by Gloriosa superba . Br Med J 1966;;1:1023-1024.
2 +
Davis JS, Bartfield H:  The effect of intravenous colchicine on acute gout . Am J Med 1954;;16:218-219.
3 +
Wallace SL, Bernstein D, Diamond H:  Diagnostic value of the colchicine therapeutic trial . JAMA 1967;;199:93-96.
4 +
Spilberg I, Gallacher A, Mehta JM, et al:  Urate crystal-induced chemotactic factor: Isolation and partial characterization . J Clin Invest 1976;;58: 815-819.
5 +
Wallace SL:  Colchicine . Semin Arthritis Rheum 1974;;3:369-381.
6 +
Rodnan GP:  Treatment of the gout and other forms of crystal-induced arthritis . Bull Rheum Dis 1982;;32:77-87.
7 +
Bain LS, Galloway DB, Petrie JC, et al:  Gout . Br Med J 1974;;1:446-448.
8 +
Ferrannini E, Pentimone F:  Marrow aplasia following colchicine treatment for gouty arthritis . Clin Exp Rheum 1984;;2:173-175.
9 +
Stapczynski JS, Rothstein RN, Gaye WA, et al:  Colchicine overdose: Report of two cases and review of the literature . Ann Emerg Med 1981;;10: 364-369.
10 +
Stanley MW, Taurog JD, Snover DC:  Fatal colchicine toxicity: Report of a case . Clin Exp Rheum 1984;;2:167-171.
11 +
Liu YK, Hymowitz R, Carroll MG:  Marrow aplasia induced by colchicine: A case report . Arthritis Rheum 1978;;21:731-735.
12 +
Wallace SL, Omokuku B, Ertel NH:  Colchicine plasma levels: Implications as to pharmacology and mechanism of action . Am J Med 1970;;48:443-448.
13 +
Malawista SE: Colchicine:  A common mechanism for its anti-inflammatory and anti-miotic effects . Arthritis Rheum 1968;;11:191-197.
14 +
Ertel NH, Wallace SL:  Measurement of colchicine in urine and peripheral leukocytes, abstracted . Clin Res 1971;;19:348A.
15 +
Chang RW, Fineberg HV:  Risk-benefit considerations in the management of polymyalgia rheumatica . Med Decis Making 1983;;3:459-475.
16 +
Fox IH, Kelley WN:  Management of gout . JAMA 1979;;242:361-364.
17 +
Freeman DL:  Frequent doses of intravenous colchicine can be lethal . N Engl J Med 1983;; 304:310.
18 +
Varga J:  On colchicine toxicity . Clin Exp Rheum 1984;;2:357.
19 +
Kelley WN, Harris ED, Ruddy S, et al: Textbook of Rheumatology . Philadelphia, WB Saunders Co, 1985;, pp 871-878.
20 +
McCarty DT (ed): Hollander's Arthritis and Allied Conditions . Philadelphia, Lea & Febiger, 1985;, pp 1507-1508.
21 +
Bennett DR (ed): AMA Drug Evaluations , ed 6. Philadelphia, WB Saunders Co, 1986;, pp 1081-1082.
22 +
Rakel RE (ed): Current Therapy . Philadelphia, WB Saunders Co, 1986;, pp 438-439.
23 +
Orland MJ, Saltman RJ (eds): Manual of Therapeutics . Boston, Little Brown & Co, 1986;, p 389.
24 +
Wyngaarden C: Textbook of Medicine . Philadelphia, WB Saunders Co, 1985;, p 1141.

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