Osteoarthritis is a major contributor to pain and disability worldwide. Given that inflammation plays an important role in the development of osteoarthritis, anti-inflammatory drugs may slow disease progression.
To examine whether colchicine, 0.5 mg daily, reduces incident total knee replacements (TKRs) and total hip replacements (THRs).
Exploratory analysis of the LoDoCo2 (Low-Dose Colchicine 2) randomized, controlled, double-blind trial. (Australian New Zealand Clinical Trials Registry: ACTRN12614000093684)
43 centers in Australia and the Netherlands.
5522 patients with chronic coronary artery disease.
Colchicine, 0.5 mg, or placebo once daily.
The primary outcome was time to first TKR or THR since randomization. All analyses were performed on an intention-to-treat basis.
A total of 2762 patients received colchicine and 2760 received placebo during a median follow-up of 28.6 months. During the trial, TKR or THR was performed in 68 patients (2.5%) in the colchicine group and 97 (3.5%) in the placebo group (incidence rate, 0.90 vs. 1.30 per 100 person-years; incidence rate difference, −0.40 [95% CI, −0.74 to −0.06] per 100 person-years; hazard ratio, 0.69 [CI, 0.51 to 0.95]). In sensitivity analyses, similar results were obtained when patients with gout at baseline were excluded and when joint replacements that occurred in the first 3 and 6 months of follow-up were omitted.
LoDoCo2 was not designed to investigate the effect of colchicine in osteoarthritis of the knee or hip and did not collect information specifically on osteoarthritis.
In this exploratory analysis of the LoDoCo2 trial, use of colchicine, 0.5 mg daily, was associated with a lower incidence of TKR and THR. Further investigation of colchicine therapy to slow disease progression in osteoarthritis is warranted.
Primary Funding Source:
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Author, Article, and Disclosure Information
Michelle W.J. Heijman,
Department of Research, Sint Maartenskliniek, and Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands (M.W.J.H., C.H.M.E.)
Department of Cardiology, University Medical Center Utrecht, and Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands (A.T.L.F.)
Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands, and Department of Cardiology, Meander Medical Center, Amersfoort, the Netherlands (A.M.)
Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands, and Cardialysis BV, Rotterdam, the Netherlands (J.G.P.T.)
Department of Pharmacy, Sint Maartenskliniek, and Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands (B.J.F.B.)
Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands (A.S.)
Department of Medicine, McMaster University, Hamilton, Ontario, Canada (J.W.E.)
Harry Perkins Institute of Medical Research, Nedlands, Western Australia, Australia, and GenesisCare Western Australia and Heart and Vascular Research Institute of Sir Charles Gairdner Hospital, Perth, Western Australia, Australia (P.L.T.)
GenesisCare Western Australia and Heart and Vascular Research Institute of Sir Charles Gairdner Hospital, Perth, Western Australia, Australia (S.M.N.)
Department of Rheumatology, Radboud University Medical Center, and Department of Rheumatology, Sint Maartenskliniek, Nijmegen, the Netherlands (C.D.P.)
Dutch Network for Cardiovascular Research (WCN), Utrecht, the Netherlands; Department of Cardiology, Radboud University Medical Center, Nijmegen, the Netherlands; and Department of Cardiology, Northwest Clinics, Alkmaar, the Netherlands (J.H.C.).
Financial Support: The authors received no financial support for research, authorship, or publication of this article.
Disclosures: Disclosures can be viewed at www.acponline.org/authors/icmje/ConflictOfInterestForms.do?msNum=M23-0289.
Data Sharing Statement: The authors have indicated they will not be sharing data. Relevant data (for example, partial data sets) will be made accessible for analyses approved by the LoDoCo2 Steering Committee. All requests for data can be made to the LoDoCo2 Steering Committee (e-mail, a.
Corresponding Author: Michelle W.J. Heijman, MSc, Department of Research, Sint Maartenskliniek, Hengstdal 3, 6574 NA, Ubbergen, the Netherlands; e-mail, m.
Author Contributions: Conception and design: M.W.J. Heijman, J.G.P. Tijssen, C.H.M. van den Ende, C.D. Popa, J.H. Cornel.
Analysis and interpretation of the data: M.W.J. Heijman, A.T.L. Fiolet, A. Mosterd, J.G.P. Tijssen, B.J.F. van den Bemt, J.W. Eikelboom, P.L. Thompson, C.H.M. van den Ende, S.M. Nidorf, C.D. Popa, J.H. Cornel.
Drafting of the article: M.W.J. Heijman, J.G.P. Tijssen, B.J.F. van den Bemt, C.H.M. van den Ende, S.M. Nidorf, C.D. Popa, J.H. Cornel.
Critical revision for important intellectual content: M.W.J. Heijman, A.T.L. Fiolet, A. Mosterd, J.G.P. Tijssen, B.J.F. van den Bemt, A. Schut, P.L. Thompson, S.M. Nidorf, C.D. Popa, J.H. Cornel.
Final approval of the article: M.W.J. Heijman, A.T.L. Fiolet, A. Mosterd, J.G.P. Tijssen, B.J.F. van den Bemt, A. Schut, J.W. Eikelboom, P.L. Thompson, C.H.M. van den Ende, S.M. Nidorf, C.D. Popa, J.H. Cornel.
Provision of study materials or patients: A.T.L. Fiolet, J.H. Cornel.
Statistical expertise: A.T.L. Fiolet, J.G.P. Tijssen.
Obtaining of funding: J.H. Cornel.
Administrative, technical, or logistic support: M.W.J. Heijman, A.T.L. Fiolet, A. Schut, C.D. Popa.
Collection and assembly of data: A.T.L. Fiolet, A. Mosterd, J.G.P. Tijssen, A. Schut, S.M. Nidorf, J.H. Cornel.
This article was published at Annals.org on 30 May 2023.
* Drs. Popa and Cornel contributed equally to this work.