Division of Rheumatology, Department of Internal Medicine, Faculty of Medicine, Chiang Mai University, Chiang Mai, Thailand.
Department of Internal Medicine, Sawanpracharak Hospital, Nakorn Sawan, Thailand.
Int J Rheum Dis. 2023 Dec;26(12):2478-2488. doi: 10.1111/1756-185X.14943. Epub 2023 Oct 20.
This study aimed to compare the efficacy of non-loading versus loading low-dose colchicine in patients with acute crystal-associated arthritis.
All in-patients who were admitted to Chiang Mai University Hospital with non-arthritis disease and developed acute crystal-associated arthritis during admission (within 48 h after arthritis onset) were invited to join this study. The patients were randomized into two groups. Patients in Group I (non-loading group) and Group II (loading group) received colchicine at 1.2 and 2.4 mg in the first 24 h, respectively. The primary outcome was the patients' pain response at 24 h after treatment.
Of 80 patients, 49 were acute gouty arthritis, and 31 acute calcium pyrophosphate (CPP) arthritis. The mean [95% CI] pain score was no different between Groups I and II at the baseline level (6.46[5.72-7.19] vs. 6.654[5.85-7.44], p = .867) and at 24 h (3.13[2.43-3.82] vs. 3.18[2.42-3.93], p = .907). The proportion of patients with ≥50% pain reduction was not different (57.50% vs. 55.00%, p = .822). Sensitivity analysis among patients with a baseline pain score of ≥4 showed the same pattern of response. Mild diarrhea was common and comparable in both groups. Subgroup analysis according to renal function (eGFR < 60 vs. ≥60 mL/min/1.73 m ) or type of crystals (acute gouty arthritis vs. acute CPP arthritis) also showed the same pattern of response.
Non-loading low-dose colchicine was as effective as loading low-dose colchicine in patients with acute crystal-associated arthritis, regardless of renal function or type of crystals.
本研究旨在比较非负荷与负荷剂量小剂量秋水仙碱治疗急性晶体相关性关节炎患者的疗效。
所有因非关节疾病住院且在住院期间（关节炎发病后 48 小时内）发生急性晶体相关性关节炎的患者均被邀请参加本研究。患者被随机分为两组。第 I 组（非负荷组）和第 II 组（负荷组）患者在 24 小时内分别接受 1.2 和 2.4mg 的秋水仙碱治疗。主要结局是治疗后 24 小时患者的疼痛反应。
80 例患者中，急性痛风性关节炎 49 例，急性焦磷酸钙（CPP）关节炎 31 例。两组患者在基线水平（6.46[5.72-7.19]vs.6.654[5.85-7.44]，p=0.867）和 24 小时（3.13[2.43-3.82]vs.3.18[2.42-3.93]，p=0.907）的疼痛评分无差异。疼痛缓解≥50%的患者比例也无差异（57.50%vs.55.00%，p=0.822）。基线疼痛评分≥4 的患者的敏感性分析也显示出相同的反应模式。两组均常见轻度腹泻，且发生率相似。根据肾功能（eGFR<60 vs.≥60mL/min/1.73m）或晶体类型（急性痛风性关节炎 vs.急性 CPP 关节炎）进行亚组分析也显示出相同的反应模式。
无论肾功能或晶体类型如何，非负荷剂量小剂量秋水仙碱与负荷剂量小剂量秋水仙碱治疗急性晶体相关性关节炎的疗效相当。
