• Michelle W J Heijman, Aernoud T L Fiolet, Arend Mosterd, TijssenJan G PJGP0000-0003-1707-2628Department of Cardiology, Amsterdam University Medical Center, Amsterdam, the Netherlands, and Cardialysis BV, Rotterdam, the Netherlands (J.G.P.T.)., van den BemtBart J FBJF0000-0002-8560-9514Department of Pharmacy, Sint Maartenskliniek, and Department of Pharmacy, Radboud University Medical Center, Nijmegen, the Netherlands (B.J.F.B.)., Astrid Schut, John W Eikelboom, Peter L Thompson, van den EndeCornelia H MCHM0000-0002-4352-2824Department of Research, Sint Maartenskliniek, and Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands (M.W.J.H., C.H.M.E.)., Stefan M Nidorf, Calin D Popa, and Jan H Cornel.
• Department of Research, Sint Maartenskliniek, and Department of Rheumatology, Radboud University Medical Center, Nijmegen, the Netherlands (M.W.J.H., C.H.M.E.).
• Ann. Intern. Med. 2023 Jun 1; 176 (6): 737742737-742.

BackgroundOsteoarthritis is a major contributor to pain and disability worldwide. Given that inflammation plays an important role in the development of osteoarthritis, anti-inflammatory drugs may slow disease progression.ObjectiveTo examine whether colchicine, 0.5 mg daily, reduces incident total knee replacements (TKRs) and total hip replacements (THRs).DesignExploratory analysis of the LoDoCo2 (Low-Dose Colchicine 2) randomized, controlled, double-blind trial. (Australian New Zealand Clinical Trials Registry: ACTRN12614000093684).Setting43 centers in Australia and the Netherlands.Patients5522 patients with chronic coronary artery disease.InterventionColchicine, 0.5 mg, or placebo once daily.MeasurementsThe primary outcome was time to first TKR or THR since randomization. All analyses were performed on an intention-to-treat basis.ResultsA total of 2762 patients received colchicine and 2760 received placebo during a median follow-up of 28.6 months. During the trial, TKR or THR was performed in 68 patients (2.5%) in the colchicine group and 97 (3.5%) in the placebo group (incidence rate, 0.90 vs. 1.30 per 100 person-years; incidence rate difference, -0.40 [95% CI, -0.74 to -0.06] per 100 person-years; hazard ratio, 0.69 [CI, 0.51 to 0.95]). In sensitivity analyses, similar results were obtained when patients with gout at baseline were excluded and when joint replacements that occurred in the first 3 and 6 months of follow-up were omitted.LimitationLoDoCo2 was not designed to investigate the effect of colchicine in osteoarthritis of the knee or hip and did not collect information specifically on osteoarthritis.ConclusionIn this exploratory analysis of the LoDoCo2 trial, use of colchicine, 0.5 mg daily, was associated with a lower incidence of TKR and THR. Further investigation of colchicine therapy to slow disease progression in osteoarthritis is warranted.Primary Funding SourceNone.

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