Patients with osteoarthritis have painful and stiff joints. Current treatment options are painkillers or major joint replacement surgery. Research by Radboudumc and the Sint Maartenskliniek now shows that colchicine, an age-old remedy for gout, is probably effective against osteoarthritis.
About one and a half million Dutch people suffer from osteoarthritis. The cartilage of one or more joints is damaged, the bone under the cartilage changes and joints are often inflamed. Osteoarthritis is painful and severely restricts patients’ freedom of movement. The only treatment options are painkillers and major joint replacement surgery. That may be about to change. Research by the Sint Maartenskliniek and Radboud university medical center gives strong indications that an age-old remedy for gout is also effective against osteoarthritis.
Colchicine
It concerns the medicine colchicine, which has been used against gout since the first century AD. It inhibits the inflammation in this condition. Years ago, Professor of Cardiology Jan Hein Cornel of Radboud university medical center and colleagues came up with the idea that this drug could work against cardiovascular diseases. Cornel explains: ‘Inflammation also plays an important role here. And we were right: in our study of more than 5,000 cardiovascular patients, colchicine reduced the risk of a heart attack, angioplasty, bypass or stroke by thirty percent.’
Rheumatologist Calin Popa of the Sint Maartens Clinic was impressed by these results and thought: maybe this drug also inhibits the inflammation in osteoarthritis. He contacted Cornel, who was immediately enthusiastic, and together they made a plan. They wanted to find out how many of the cardiovascular patients in the colchicine study had had a new knee or hip.
Safe and cheap
Michelle Heijman, researcher at the Sint Maartenskliniek, conducted the research. ‘The drug does indeed seem to work against osteoarthritis. The number of patients with a knee or hip replacement was more than thirty percent lower in the group treated with colchicine than in the placebo group. Because it’s such an old drug, we know it’s safe. And the treatment is easy: one tablet once a day, prescribed by the GP.’
Popa also sees a promising future for colchicine as an osteoarthritis treatment: ‘There are other drugs that also seem to have an effect against osteoarthritis, but they are either less safe or very expensive. Colchicine only costs a few tenners a year. Because osteoarthritis is so common, the cost savings can be enormous.’
Follow-up research
Patients with osteoarthritis cannot yet be treated with colchicine. Because the study used data from a study of cardiovascular patients, doctors cannot yet prescribe the drug for osteoarthritis. That is why Popa and Cornel want to conduct follow-up research specifically aimed at osteoarthritis.
‘If we can confirm that colchicine works, that’s fantastic news,’ says Popa. ‘We will finally be able to offer osteoarthritis patients a safe and effective remedy. This greatly improves their quality of life and in some cases could postpone or even prevent major surgery. That saves healthcare costs. In short: a win-win-win situation.’
About the publication
This research was published in the Annals of Internal Medicine: Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements. MWJ Heijman, ATL Fiolet, A. Mosterd, JGP Tijssen, BJF van den Bemt, A. Schut, JW Eikelboom, PL Thompson, CHM van den Ende, SM Nidorf, CD Popa, JH Cornel. DOI: 10.7326/M23-0289
Are you a patient with osteoarthritis and are you looking for more information about colchicine and the follow-up study? Then click here to be redirected to the Sint Maartenskliniek page on this subject.
2023-05-31 23:21:01
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