Intravenous colchicine use in crystal-induced arthropathies: a retrospective analysis of hospitalized patients.

OBJECTIVES

To assess current prescribing patterns, and adherence to recommended practice guidelines, for the use of intravenous colchicine in the treatments of crystal-induced arthropathies.

METHODS

Medical records of patients at an urban academic medical center who received intravenous colchicine were reviewed. Information about colchicine dosing and clinical outcomes, with particular attention to interventions by Rheumatologists, was obtained. All hospitalized patients with confirmed or suspected crystal-induced arthropathies treated with intravenous colchicine during a 48-month period were included in this retrospective study. The demographic profile, medical history and clinical data were reviewed.

RESULTS

Intravenous colchicine dosing schedules generally followed recommended guidelines. There was no significant difference between patients evaluated by a Rheumatologist, and those that were not, in the cumulative colchicine dose received, clinical response, or length of hospitalization. Relative contraindications to intravenous colchicine were present frequently, but no morbidity or mortality directly attributable to intravenous colchicine was recorded. Patients evaluated by a Rheumatologist prior to receiving intravenous colchicine were significantly more likely to have the diagnosis of a crystal-induced arthropathy confirmed by the identification of crystals from synovial fluid, and less likely to have received oral colchicine prior to intravenous colchicine, than patients who were not evaluated by a Rheumatologist.

CONCLUSIONS

Increased involvement of Rheumatologists, and increased awareness of the appropriate indications and guidelines for the safe administration of intravenous colchicine are recommended.