colchicine and acute gout

16 Aug


— When seeing a patient during an attack: 1.2mg cochicine then 0.6mg 1 hr later has done well in treating acute gout.

still open whether it compares better than NSAID, glucocorticoid, or IL-1 inhibitors.

— Low dose colcichine was studied in the AGREE trial- showed that lower dose groups ( the 1 day dose or 0.5 TID) had similar effects as the higher dose group with less side effects.

— Subjects in the low-dose treatment group experienced diarrhea (23 percent) or other GI symptoms no more often than placebo-treated subjects (16 percent diarrhea) during the trial, but diarrhea occurred in 77 percent of higher-dose-treated subjects (odds ratio 21.3; CI 8-57). Diarrhea was graded as severe in 19 percent of high-dose treatment subjects versus 0 percent in the low-dose group, and vomiting was seen in 17 percent in the high-dose group but 0 percent in the other groups



–In the end, I think colchicine 1.2mg followed by 0.6mg and follow up with PCP will be my regimen.


Submitted by J. Rothstein.


Reference(s): treatment of acute gout; fda recommendations. picture



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