Colchicine: Old and New

Abstract

Although colchicine has been a focus of research, debate and controversy for thousands of years, it was only approved by the United States Food and Drug Administration in 2009. Over the past decade, advances in the knowledge of colchicine pharmacology, drug safety and mechanisms of action have led to changes in colchicine dosing and to potential new uses for this very old drug. In this review, we discuss the pharmacologic properties of colchicine and summarize what is currently known about its mechanisms of action. We then discuss and update the use of colchicine in a variety of illnesses, including rheumatic and, most recently cardiovascular diseases.

Colchicine therapy in acute coronary syndrome patients acts on caspase-1 to suppress NLRP3 inflammasome monocyte activation

“…We have recently demonstrated that short-term colchicine therapy in ACS patients reduces local coronary production of the inflammasome-specific cytokines, IL-1β and IL-18 as well as downstream IL-6 (15). Several anti-inflammatory mechanisms of colchicine have previously been reported including the inhibition of NLRP3 inflammasome protein assembly in macrophages by disrupting microtubule formation (17) as well as reducing neutrophil infiltration (18). Nonetheless, the mechanism of action of colchicine in the setting of ACS is still to be determined.…”

Efficacy of colchicine in a child with relapsing bullous Henoch-Schönlein purpura

“…It is effective for gout, Fig. 1 Photographs of legs before (left) and a few weeks after (right) the administration of colchicine in a 5-year-old boy with chronic severe cutaneous lesions of Henoch-Schönlein purpura familial Mediterranean fever (FMF), Behcet's disease, and neutrophilic dermatoses, all characterized by neutrophil accumulation or increased neutrophil function responsible for an enhanced inflammatory response [9]. The coexistence of FMF with HSP is well recognized, but whether MEFV gene mutations may affect HSP clinical presentation is unclear [2].…”

“…Nonsteroidal anti-inflammatory drugs are effective for arthritis and arthralgia, but their effectiveness in cutaneous manifestations of HSP has not been reported. Colchicine is mentioned as a therapeutic option for cutaneous vasculitis in adults but is not usually mentioned in textbooks or recent reviews of HSP in children [9].…”

Þvagsýrugigt - læknanleg liðbólga

“…49 Þá hindrar það einnig viðloðun daufkyrninga við aeðaveggi og minnkar þannig flutning þeirra úr aeðum inn í vefi. 50 Áður fyrr voru leiðbeiningar til meðferðar þvagsýrugigtar með colchicine þaer að gefa átti lyfið í háum skömmtum, 1,5 mg og síðan 0,5 mg á klukkustundar fresti þar til sjúklingur varð verkjalaus eða fékk niðurgang, að hámarki 8 töflur. Þetta leiddi til þess að margir urðu fráhverfir notkun colchicine því aukaverkanirnar geta verið mjög svaesnar.…”