Department of Cardiology, Prince of Wales Hospital, Sydney, New South Wales, Australia.
Faculty of Medicine, The University of New South Wales, Sydney, New South Wales, Australia.
Rheumatology (Oxford). 2018 Feb 1;57(2):382-387. doi: 10.1093/rheumatology/kex353.
Colchicine is an anti-inflammatory agent used in the treatment of several rheumatological conditions. The use of colchicine in pregnancy is controversial. The current study aimed to systematically review and meta-analyse the existing data in the literature regarding the safety of colchicine in pregnancy.
A systematic review was carried out using six electronic databases, identifying all relevant studies where colchicine was administered to pregnant women, and where pregnancy-related outcomes were measured. The primary endpoints were miscarriage and major foetal malformation. Secondary endpoints included birthweight and gestational age at birth.
Four studies were included for meta-analysis. Use of colchicine throughout pregnancy was not associated with an increased incidence of miscarriage or major foetal malformations. The incidence of miscarriage was significantly lower in women who took colchicine compared with those that did not. In women with FMF who took colchicine throughout the pregnancy, there was no significant difference in birthweight or gestational age compared with those who did not take colchicine. When not limited to FMF, colchicine use was associated with a significantly lower birthweight and gestational age compared with a control group including healthy women who did not take colchicine.
Colchicine therapy did not significantly increase the incidence of foetal malformations or miscarriage when taken during pregnancy. Colchicine therapy for FMF should not be withheld on this basis during pregnancy.
秋水仙碱是一种用于治疗多种风湿性疾病的抗炎药。秋水仙碱在怀孕期间的使用存在争议。本研究旨在系统地回顾和荟萃分析文献中关于秋水仙碱在怀孕期间安全性的现有数据。
使用六个电子数据库进行系统评价，确定所有将秋水仙碱用于孕妇并测量与妊娠相关结局的相关研究。主要终点是流产和主要胎儿畸形。次要终点包括出生体重和出生时的胎龄。
有 4 项研究被纳入荟萃分析。整个孕期使用秋水仙碱与流产或主要胎儿畸形的发生率增加无关。与未服用秋水仙碱的女性相比，服用秋水仙碱的女性流产发生率明显较低。在整个孕期服用秋水仙碱的 FMF 女性中，与未服用秋水仙碱的女性相比，出生体重或胎龄无显著差异。当不限于 FMF 时，与未服用秋水仙碱的健康对照组相比，秋水仙碱的使用与较低的出生体重和胎龄相关。
在怀孕期间服用秋水仙碱并不会显著增加胎儿畸形或流产的发生率。因此，基于此，FMF 患者在怀孕期间不应停用秋水仙碱治疗。
