Association of colchicine use for acute gout with clinical outcomes in acute decompensated heart failure

Abstract

Background Gout is a common comorbidity in heart failure (HF) patients and is frequently associated with acute exacerbations during treatment for decompensated HF. Although colchicine is often used to manage acute gout in HF patients, its impact on clinical outcomes when used during acute decompensated HF is unknown. Methods This was a single center, retrospective study of hospitalized patients treated for an acute HF exacerbation with and without acute gout flare between March 2011 and December 2020. We assessed clinical outcomes in patients treated with colchicine for a gout flare compared to those who did not experience a gout flare or receive colchicine. The primary outcome was in‐hospital all‐cause mortality. Results Among 1047 patient encounters for acute HF during the study period, there were 237 encounters (22.7%) where the patient also received colchicine for acute gout during admission. In‐hospital all‐cause mortality was significantly reduced in the colchicine group compared with the control group (2.1% vs. 6.5%, p = .009). The colchicine group had increased length of stay (9.93 vs. 7.96 days, p < .001) but no significant difference in 30‐day readmissions (21.5% vs. 19.5%, p = .495). In a Cox proportional hazards model adjusted for age, inpatient colchicine use was associated with improved survival to discharge (hazards ratio [HR] 0.163, 95% confidence interval [CI] 0.051−0.525, p = .002) and a reduced rate of in‐hospital CV mortality (HR 0.184, 95% CI 0.044−0.770, p = .021). Conclusion Among patients with a HF exacerbation, treatment with colchicine for a gout flare was associated with significantly lower in‐hospital mortality compared with those not treated for acute gout.

Toxic Effects of Koumine on the Early-Life Development Stage of Zebrafish

“…Alkaloid compounds are widely distributed, and most have significant biological activity [18,19]. For example, berberine has anti-inflammatory effects [20], reserpine can lower blood pressure, morphine has analgesic effects [21], and colchicine can treat gout [22]. It is worth noting that most of the alkaloids are accompanied by toxic effects, and the application presupposes a good toxicological test.…”

Personalizing anti‐inflammatory therapy in heart failure: A new way

“…No other randomized studies have been published. In a recent retrospective analysis, use of colchicine in the context of gout among hospitalized HF patients was associated with lower risk of HF readmissions 17 . Currently, as reported in ClinicalTrials.gov, there is only one ongoing trial with a double‐blind placebo‐controlled design.…”

“…In a recent retrospective analysis, use of colchicine in the context of gout among hospitalized HF patients was associated with lower risk of HF readmissions. 17 Currently, as reported in ClinicalTrials.gov, there is only one ongoing trial with a double-blind placebo-controlled design. The COLICA trial (NCT04705987), led by our group, is currently investigating the impact of high doses of colchicine in individuals experiencing acute decompensated HF, regardless of their left ventricular ejection fraction.…”

Cardiovascular risk in patients with acute gout: is there any association and need for treatment?

“…Por su parte, Roth et al (6) evaluaron la utilidad de la colchicina para la crisis gotosa y su relación con desenlaces clínicos en falla cardiaca descompensada; evidenciaron que de 1047 pacientes (de los cuales 237 recibieron colchicina), existió una reducción significativa de la mortalidad intrahospitalaria en el grupo colchicina (2,1% vs. 6,5%; p=0,009), sin diferencias en la readmisión a 30 días (21,5% vs. 19,5%; p=0,495) (6) . Esto permitió concluir a los autores que la colchicina podría impactar sobre la mortalidad intrahospitalaria en aquellos con crisis gotosa y falla cardiaca descompensada.…”