Severe Colchicine Intoxication in a Renal Transplant Recipient on Cyclosporine

Garrouste, Cyril; Philipponnet, Carole; Kaysi, S.; Enache, Ioana; Tiple, A.; Heng, A. E.

doi:10.1016/j.transproceed.2012.09.028

Cited by 21 publications

(12 citation statements)

References 9 publications

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“…In addition, we have seen different results on the impact of gout flare treatment on renal function in case reports and case series. For instance, 12 studies reported deteriorated renal function with colchicine use [17,20,22,24,32,33,35,39,44,53,55,57], whereas 7 other studies reported stable renal function with colchicine use [18,28,29,31,36,46,53]. As a result, given the underlying risk of bias on study quality for these studies, we cannot sufficiently conclude on the efficacy and/or safety outcomes on colchicine use for people with gout and concomitant CKD.…”

Section: Discussionmentioning

confidence: 99%

“…Nine studies reported colchicine toxicity secondary to drug-drug interaction with statin, cyclosporin, clarithromycin, and hepatitis C treatments (i.e. sofosbuvir/ledipasvir) [17,18,28,29,31,32,36,46,49]. It was unclear from these studies if the reported adverse events were directly attributed to the colchicine use.…”

Section: Studies Of Colchicine Use With Analyses Stratified By Renal Functionmentioning

confidence: 99%

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Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

et al. 2021

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Gout flare prophylaxis and therapy use in people with underlying chronic kidney disease (CKD) is challenging, given limited treatment options and risk of worsening renal function with inappropriate treatment dosing. This literature review aimed to describe the current literature on the efficacy and safety of gout flare prophylaxis and therapy use in people with CKD stages 3–5. A literature search via PubMed, the Cochrane Library, and EMBASE was performed from 1 January 1959 to 31 January 2018. Inclusion criteria were studies with people with gout and renal impairment (i.e. estimated glomerular filtration rate (eGFR) or creatinine clearance (CrCl) < 60 ml/min/1.73 m2), and with exposure to colchicine, interleukin-1 inhibitors, non-steroidal anti-inflammatory drugs (NSAIDs), and glucocorticoids. All study designs were included. A total of 33 studies with efficacy and/or safety analysis stratified by renal function were reviewed—colchicine (n = 20), anakinra (n = 7), canakinumab (n = 1), NSAIDs (n = 3), and glucocorticoids (n = 2). A total of 58 studies reported these primary outcomes without renal function stratification—colchicine (n = 29), anakinra (n = 10), canakinumab (n = 6), rilonacept (n = 2), NSAIDs (n = 1), and glucocorticoids (n = 10). Most clinical trials excluded study participants with severe CKD (i.e. eGFR or CrCl of < 30 mL/min/1.73 m2). Information on the efficacy and safety outcomes of gout flare prophylaxis and therapy use stratified by renal function is lacking. Clinical trial results cannot be extrapolated for those with advanced CKD. Where possible, current and future gout flare studies should include patients with CKD and with study outcomes reported based on renal function and using standardised gout flare definition.

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Section: Discussionmentioning

confidence: 99%

Section: Studies Of Colchicine Use With Analyses Stratified By Renal Functionmentioning

confidence: 99%

Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

et al. 2021

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“…Previous studies have demonstrated that colchicine induces severe rhabdomyolysis in solid organ transplant patients when used for the treatment of acute gout arthritis (13,14). The causes may be attributed to the concurrent use of P-glycoprotein inhibitors, such as cyclosporin, pravastatin and azithromycin, high doses or impaired renal or hepatic functions (13,14). However, in the present case, during the 12-month period of colchicine treatment, only modest transient reversible side effects were observed and the allograft function remained stable.…”

Section: Discussionmentioning

confidence: 99%

Post-transplant recurrent pericarditis with pericardial tamponade is successfully treated with colchicine: A case report

Gao

Peng

2014

Experimental and Therapeutic Medicine

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Recurrent pericarditis is a rare complication following renal transplantation. Colchicine, an inhibitor of microtubule polymerization, has been recommended for the treatment of recurrent acute pericarditis in non-transplant patients and is commonly used for the treatment of gout in transplant patients. However, the use of colchicine for the treatment of recurrent pericarditis in renal transplant patients has rarely been reported. In the present study, a rare case of recurrent pericarditis, manifested as large pericardial effusion and pericardial tamponade within the first year following renal transplantation, was successfully treated with colchicine. Therefore, low-dose colchicine may be a safe and effective option for the treatment of recurrent pericarditis in renal transplant patients.

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“…Various other antimicrobial agents including triazole antifungals, linezolid, ethambutol, and isoniazid can also cause toxic neuropathy [92]. Posttransplant rhabdomyolysis may be precipitated by interaction of statins and colchicine with CNIs [93,94].…”

Section: Neurotoxicity From Other Medicationsmentioning

confidence: 99%

The Neurology of Solid Organ Transplantation

Avila

Živković

2015

Curr Neurol Neurosci Rep

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Transplantation is the rescue treatment for end-stage organ failure with more than 110,000 solid organs transplantations performed worldwide annually. Recent advances in transplantation procedures and posttransplantation management have improved long-term survival and quality of life of transplant recipients, shifting the focus from acute perioperative critical care needs toward long-term chronic medical problems. Neurologic complications affect up to 30-60 % of solid organ transplant recipients. Common etiologies include opportunistic infections and toxicities of antirejection medications, and wide spectrum of toxic and metabolic disturbances. Most complications are common to all allograft types, but some are relatively specific for individual allograft types (e.g., central pontine myelinolysis in liver transplant recipients). Close collaboration between neurologists and other transplant team members is essential for effective management. Early recognition of complications and accurate diagnosis leading to timely treatment is essential to reduce the morbidity and improve the overall transplant outcome.

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Severe Colchicine Intoxication in a Renal Transplant Recipient on Cyclosporine

Cited by 21 publications

References 9 publications

Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

Efficacy and safety of gout flare prophylaxis and therapy use in people with chronic kidney disease: a Gout, Hyperuricemia and Crystal-Associated Disease Network (G-CAN)-initiated literature review

Post-transplant recurrent pericarditis with pericardial tamponade is successfully treated with colchicine: A case report

The Neurology of Solid Organ Transplantation

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