Intravenous colchicine in the treatment of acute pseudogout

Tabatabai, M. Reza; Cummings, Norman A.

doi:10.1002/art.1780230320

Cited by 28 publications

(11 citation statements)

References 21 publications

(13 reference statements)

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“…The length of treatment depends on the symptom relief and side effects. Although one uncontrolled hospital case series has showed the efficacy of intravenous colchicine in seven patients with acute CPP crystal arthritis,16 this route of delivery is no longer used in most countries owing to the high risk of serious toxicity (and even fatality).…”

Section: Resultsmentioning

confidence: 99%

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

et al. 2011

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Objectives To develop evidence-based recommendations for management of calcium pyrophosphate deposition (CPPD). Methods A multidisciplinary guideline development group of 15 experts, representing 10 European countries, generated key propositions for management of CPPD using a Delphi consensus approach. For each recommendation research evidence was searched systematically. Whenever possible, the effect size and number needed to treat for effi cacy and RR or OR for side effects were calculated for individual treatment modalities. Strength of recommendation was assessed by the European League Against Rheumatism visual analogue scale. Results Nine key recommendations were generated, including topics for general management, treatment of acute attacks, prophylaxis against recurrent acute attacks and management of chronic symptoms. It was recommended that optimal treatment requires both non-pharmacological and pharmacological treatments. For acute CPP crystal arthritis, cool packs, temporary rest and joint aspiration combined with steroid injection are often suffi cient. For prophylaxis or chronic infl ammatory arthritis with CPPD, oral non-steroidal anti-infl ammatory drugs with gastroprotective treatment and/or low-dose colchicine 0.5-1.0 mg daily may be used. Other recommendations included parenteral or oral corticosteroid for acute CPP arthritis in those unresponsive or unsuited to other measures, and lowdose corticosteroid, methotrexate or hydroxychloroquine for chronic infl ammatory arthritis with CPPD. Asymptomatic CPPD requires no treatment. Strength of recommendations varies from 79% to 95%. Conclusion Nine key recommendations for management of CPP crystal associated arthritis were developed using both research evidence and expert consensus. Strength of recommendations was provided to assist the application of these recommendations.

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Section: Resultsmentioning

confidence: 99%

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

et al. 2011

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“…Recent European League Against Rheumatism (EULAR) guidelines recommend colchicine 0.5 mg three times daily with or without a 1 mg loading dose for acute attacks and colchicine 0.5 mg daily for prophylaxis, based largely on expert opinion and a single uncontrolled trial. 42,43 …”

Section: Colchicine In Rheumatic Diseasesmentioning

confidence: 99%

Colchicine: Old and New

Slobodnick

Shah

Pillinger

et al. 2015

The American Journal of Medicine

255

158

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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.

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“…With such high doses, the incidence of marked side effects was almost 100%. 37 – 39 We prefer to use an alternative low-dose COL regimen that is 0.6 mg (or 0.5 mg available in other countries other than the US) three times per day on the first days of treatment. In most patients, the effect of this oral therapy is dramatic; joint symptoms usually begin to subside in 12–24 hours, and the attack has abated, if treated early, in 72 hours, with fewer toxic effects.…”

Section: Managementmentioning

confidence: 99%

“…The effectiveness of COL as a prophylactic agent in recurring CPP crystal arthritis was shown in a study 39 in which 10 patients with recurrent arthritis attacks were started on this drug (oral COL 0.6 mg, two times daily) and followed for 1 year after receiving the therapy. Acute episodes of arthritis were diminished from 3.2 patients/year to one patient/year (90% of the patients benefitted from COL use).…”

Section: Managementmentioning

confidence: 99%

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Calcium pyrophosphate crystal deposition disease: diagnosis and treatment

Rosales-Alexander

Aznar

Magro-Checa

2014

OARRR

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Calcium pyrophosphate dihydrate crystal deposition disease (CPPD) is an inflammatory arthritis produced by the deposition of calcium pyrophosphate (CPP) crystals in the synovium and periarticular soft tissues. It is the third most common inflammatory arthritis. Diagnosis is suspected on the basis of the clinical picture and radiographic/laboratory findings. The reference standard for the diagnosis of CPPD is based on the identification of CPP crystals in synovial fluid by light microscopy, compensated polarized light microscopy, or phase contrast microscopy. Most treatment approaches for CPPD are based upon clinical experience and not upon controlled trials. They range – depending on the subtype and the characteristics of symptoms – from no treatment to interleukin-1 blockade antibodies or specific therapy for an underlying disease. This review summarizes all we know so far about the diagnosis and management of CPPD.

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Intravenous colchicine in the treatment of acute pseudogout

Cited by 28 publications

References 21 publications

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

EULAR recommendations for calcium pyrophosphate deposition. Part II: Management

Colchicine: Old and New

Calcium pyrophosphate crystal deposition disease: diagnosis and treatment

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