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Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial.

Publication ,  Journal Article
Leung, YY; Haaland, B; Huebner, JL; Wong, SBS; Tjai, M; Wang, C; Chowbay, B; Thumboo, J; Chakraborty, B; Tan, MH; Kraus, VB
Published in: Osteoarthritis Cartilage
May 2018

OBJECTIVES: Uric acid may activate an innate immune response in osteoarthritis (OA), contributing to disease pathology and progression. We evaluated the effectiveness of colchicine on pain and function in symptomatic knee OA (KOA) and the underlying mechanism of action. METHODS: Colchicine effectiveness in symptoms and inflammation modification in knee osteoarthritis (COLKOA) was a double-blind, placebo-controlled, randomized trial comparing 16 weeks of treatment with 0.5 mg twice-daily oral colchicine to placebo for knee osteoarthritis (KOA). The primary endpoint was ≥30% improvement in total Western Ontario and McMaster Universities Osteoarthritis Index (WOMAC) score at week 16. Secondary endpoints included improvement in pain (0-10 Likert scales); WOMAC pain; patient global assessment (0-100); physical function; the OARSI-OMERACT response; quality of life; and change in serum, urine, synovial fluid (SF) biomarkers of cartilage metabolism and inflammation, and plasma/SF colchicine concentrations. RESULTS: Of 109 randomly assigned participants, 39% (95% confidence interval (CI) 27-52%) and 49% (95% CI 36-62%) in the colchicine and placebo arms respectively met the primary endpoint at study end (P = 0.284, odds ratio 0.66, 95% CI 0.31-1.41). No strong evidence of treatment differences was identified on clinical secondary endpoints. Treatment significantly reduced mean serum hs-CRP (P = 0.008) and SF CTXI (P = 0.002); treatment tended to reduce inflammatory markers (SF IL-6, IL8, TNFα, CD14 and IL-18), but these differences were not statistically significant. CONCLUSION: Colchicine (0.5 mg twice-daily orally) reduced inflammation and high bone turnover biomarkers known to be associated with OA severity and progression risk, but did not reduce KOA symptoms over a 16-week study period. A longer-term study to evaluate for slow-acting disease modifying effects is warranted. TRIAL REGISTRATION: The trial has been registered at clinicaltrials.gov as NCT02176460. Date of registration: June 26, 2014.

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Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

May 2018

Volume

26

Issue

5

Start / End Page

631 / 640

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Synovial Fluid
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Inflammation
  • Humans
  • Female
  • Double-Blind Method
 

Citation

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Leung, Y. Y., Haaland, B., Huebner, J. L., Wong, S. B. S., Tjai, M., Wang, C., … Kraus, V. B. (2018). Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial. Osteoarthritis Cartilage, 26(5), 631–640. https://doi.org/10.1016/j.joca.2018.01.026
Leung, Y. Y., B. Haaland, J. L. Huebner, S. B. S. Wong, M. Tjai, C. Wang, B. Chowbay, et al. “Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial.Osteoarthritis Cartilage 26, no. 5 (May 2018): 631–40. https://doi.org/10.1016/j.joca.2018.01.026.
Leung YY, Haaland B, Huebner JL, Wong SBS, Tjai M, Wang C, et al. Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial. Osteoarthritis Cartilage. 2018 May;26(5):631–40.
Leung, Y. Y., et al. “Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial.Osteoarthritis Cartilage, vol. 26, no. 5, May 2018, pp. 631–40. Pubmed, doi:10.1016/j.joca.2018.01.026.
Leung YY, Haaland B, Huebner JL, Wong SBS, Tjai M, Wang C, Chowbay B, Thumboo J, Chakraborty B, Tan MH, Kraus VB. Colchicine lack of effectiveness in symptom and inflammation modification in knee osteoarthritis (COLKOA): a randomized controlled trial. Osteoarthritis Cartilage. 2018 May;26(5):631–640.
Journal cover image

Published In

Osteoarthritis Cartilage

DOI

EISSN

1522-9653

Publication Date

May 2018

Volume

26

Issue

5

Start / End Page

631 / 640

Location

England

Related Subject Headings

  • Young Adult
  • Treatment Outcome
  • Synovial Fluid
  • Osteoarthritis, Knee
  • Middle Aged
  • Male
  • Inflammation
  • Humans
  • Female
  • Double-Blind Method