Ben-Chetrit E, Levy M
Department of Medicine, Hadassah University Hospital, Jerusalem, Israel.
Semin Arthritis Rheum. 1998 Aug;28(1):48-59. doi: 10.1016/s0049-0172(98)80028-0.
To present an update of the use of colchicine in patients with familial Mediterranean fever (FMF) and other rheumatic and nonrheumatic diseases.
Published studies on colchicine retrieved from MEDLINE searches from 1987 to 1997 and reports presented at national and international meetings. STUDIES SELECTION AND EXTRACTION: All studies were reviewed by the authors. Reports addressing the topics of colchicine pharmacokinetics, biological effects, indications for use, and side effects were selected.
Colchicine is an alkaloid that may interfere with microtubule formation, thereby affecting mitosis and other microtubule-dependent functions. It has a bioavailability of 25% to 50% when administered orally. Colchicine and its metabolites are excreted through the urinary and biliary tracts. It may be used while breast feeding; however, amniocentesis should be performed when used in pregnancy. The drug may be given to children with FMF. The efficacy of colchicine has been proved in FMF, gout, Behcet's disease, and cirrhosis. Its place in the treatment of scleroderma, sarcoidosis, and skin disorders remains to be determined. Gastrointestinal side effects occur early and are most common manifestations of colchicine toxicity. Severe colchicine toxicity results in multiple organ failure, convulsions, coma, and death. Potentially, effective treatment with Fab anti-colchicine antibodies unfortunately is unavailable; therefore, treatment is supportive.
Colchicine is a relatively safe and effective medication for several disorders when used in appropriate dosage in patients with normal kidney and liver function.
介绍秋水仙碱在家族性地中海热（FMF）及其他风湿性和非风湿性疾病患者中的应用最新情况。
从1987年至1997年MEDLINE检索中获取的关于秋水仙碱的已发表研究以及在国内和国际会议上发表的报告。研究选择与提取：所有研究均由作者进行审查。选取了涉及秋水仙碱药代动力学、生物学效应、使用指征及副作用等主题的报告。
秋水仙碱是一种生物碱，可能会干扰微管形成，从而影响有丝分裂及其他依赖微管的功能。口服时其生物利用度为25%至50%。秋水仙碱及其代谢产物通过尿液和胆道排泄。哺乳期可使用；然而，孕期使用时应进行羊膜穿刺术。该药可用于患FMF的儿童。秋水仙碱在FMF、痛风、白塞病和肝硬化中的疗效已得到证实。其在硬皮病、结节病和皮肤病治疗中的地位尚待确定。胃肠道副作用出现较早，是秋水仙碱毒性最常见的表现。严重的秋水仙碱毒性会导致多器官功能衰竭、惊厥、昏迷和死亡。遗憾的是，目前尚无有效的抗秋水仙碱Fab抗体治疗方法；因此，治疗以支持治疗为主。
对于肾功能和肝功能正常的患者，以适当剂量使用时，秋水仙碱对多种疾病是一种相对安全有效的药物。
