“Colchicine: A Promising Cheap and Safe Remedy for Osteoarthritis Patients”

Pain and limited freedom of movement, often resulting in an unavoidable operation: that is what many osteoarthritis patients have to live with. The disease is currently being treated with painkillers and physiotherapy, but Radboudumc and the Sint Maartenskliniek have now discovered that an age-old, cheap and safe remedy can also help. With one tablet a day for a few tens a year, the pain of an osteoarthritis patient could be relieved.

“It’s really very promising,” says cardiologist Jan Hein Cornel of Radboudumc. He previously researched the use of the drug in cardiovascular disease.

Fewer operations

It’s a bit technical, but colchicine is currently used in patients with gout, an inflammation of a joint. That inflammation is accompanied by a buildup of uric acid crystals, which are sharp and pointy and poke at the joint. Colchicine inhibits inflammation.

Cholesterol works similarly, because it also contains sharp crystals. That is why cardiologist Jan Hein Cornel came up with the idea of ​​investigating whether colchicine would also help cardiovascular patients. “These results turned out to be astonishing. Patients who received colchicine needed a bypass 30 percent less often and had a heart attack or stroke 30 percent less often,” says Cornel.

Then the link was made with osteoarthritis. There are underlying mechanisms at work that lead to cardiovascular disease on the one hand and osteoarthritis on the other. The study of cardiovascular patients then looked at patients who also suffer from osteoarthritis.

It turned out that there was a ‘spectacular difference’ between the group that took colchicine and the group that didn’t. “Everyone who had had the drug appeared to have received a replacement joint less often,” the cardiologist explains.

‘Muddling through’

For osteoarthritis patient Valerie Bodelier, it would be ‘completely fantastic’ if colchicine indeed proves to be effective against the joint disease. She has been suffering from it for seven years and has a lot of trouble with it. “It’s a bit of muddling through in life,” she says.

It is impossible to predict when the pain will increase again, but when it does, she cannot do much. “Sometimes it’s not even possible to put on socks,” she says. “My circle of friends and social world are getting smaller and smaller, because I can’t always just do something fun.”

Bodelier hopes that colchicine can help her, so that she may not need a hip replacement. “I live in a world with too much pain. If this works it would mean I can get out more often, sleep better and have a better quality of life.”

New research

Before the drug can also be made available to osteoarthritis patients, research must first be carried out. “We now have strong indications that it helps, but it will be some time before general practitioners can prescribe it to osteoarthritis patients,” says rheumatologist Calin Popa of the Sint Maartens Clinic. He is participating in research into the effect of colchicine in osteoarthritis patients.

In principle, all osteoarthritis patients should be eligible for the use of colchicine. “For practical reasons, in our future research we will only study patients who have osteoarthritis of the knee or hip,” says Popa. This group makes up two-thirds of osteoarthritis patients.

If it indeed turns out that colchicine is effective against osteoarthritis, the drug could become available to osteoarthritis patients ‘rather quickly’, according to Popa. “The drug is already on the market and the Medicines Evaluation Board (MEB) and the National Health Care Institute (ZIN) are already aware of the research and support it.”

Radboudumc and the Sint Maartenskliniek hope to start the research in the spring of 2024. Whether that succeeds depends on whether they have the financial resources for it. The investigation will take four and a half years.