Colchicine therapy for low-dose-methotrexate-induced accelerated nodulosis in a rheumatoid arthritis patient.

Accelerated nodulosis developed on the fingers of a woman successfully treated with low dose methotrexate for rheumatoid arthritis. Colchicine therapy resulted in regression of these nodules for twelve months. To our knowledge, this is the first report in the dermatological literature on this relatively new entity in which the skin is also involved.     

Beneficial effects of colchicine in experimental nephrotoxic serum nephritis in the rat

Abstract. Glomerulonephritis was induced in rats by multiple injections of rabbit anti-rat kidney serum. Colchicine was administered daily for 4 months to nephrotoxic serum treated rats and untreated control animals. Nephritic rats receiving colchicine had significantly less proteinuria and less glomerular damage than unprotected nephritic animals. A possible role for colchicine in the early treatment of human glomerulonephritis is suggested.     

Pretreatment with corticosteroids attenuates the efficacy of colchicine in preventing recurrent pericarditis: a multi-centre all-case analysis.

AIMS: Effective prevention of recurrent pericarditis remains an important yet elusive goal. Corticosteroid therapy often needs to be continued for a prolonged period and causes severe side effects. We performed a multi-centre all-case analysis to investigate the efficacy of colchicine in preventing subsequent relapses of pericarditis, and addressed the hypothesis that pretreatment with corticosteroids may attenuate the beneficial effect of colchicine. METHODS AND RESULTS: One hundred and forty published and unpublished cases of patients treated with colchicine after at least two relapses of pericarditis were aggregated from European centres. Of those, 119 were included in the study group. Only 18% of the patients had relapses under colchicine therapy, and 30% after its discontinuation. There were significantly more relapses among male patients after colchicine treatment (36 vs. 17%, P=0.046), and those with previous corticosteroid treatment (43 vs. 13%, P=0.02). Multivariate logistic regression analysis identified previous corticosteroid therapy (OR 6.68, 95% CI: 1.65-27.02) and male gender (OR 4.20, 95% CI: 1.16-15.21) as independent risk factors for recurrence following colchicine therapy. CONCLUSION: Treatment with colchicine is highly effective in preventing recurrent pericarditis, while pretreatment with corticosteroids exacerbates and extends the course of recurrent pericarditis.     

Colchicine and myocardial infarction: A review

Central illustration. Potential impact of colchicine on the pathways involved in atherosclerosis. IL: interleukin; MMP: matrix metalloproteinase; SMC: smooth muscle cells. Adapted from [42].

     

Colchicine et inflammation oculaire non sévère hors maladie de Behcet : 16 cas et revue de la littérature

IntroductionColchicine is a narrow therapeutic margin drug that does not have the adverse effects of corticosteroids and immunosuppressants. Its use in non-severe ocular inflammatory disease excluding Behcet's disease has not been studied.MethodsWe included patients seen in the internal medicine department of Dijon University Hospital consecutively between September 2020 and September 2021 if they had received colchicine during their pathology. Patients with suspected Behçet's disease were excluded. Treatment efficacy was studied in patients with at least one year of disease progression who had received more than one year of colchicine. Successful treatment was defined as a 50 % reduction in the number of annual relapses on colchicine.ResultsSixteen patients were included (9 women and 7 men). They had recurrent anterior uveitis (n = 10), recurrent scleritis (n = 5) and intermediate uveitis. Opthalmological involvement was neither severe nor complicated. All patients combined, the annual relapse ratio (ARR) decreased from 1.8 (0.8–3.5) to 0.3 (0–1.6), (P = 0.06). Colchicine was considered effective in three of 10 analyzable patients. In only one patient, treatment was stopped for adverse effects after six weeks.ConclusionIn view of the interesting benefit-risk ratio of colchicine, it seems appropriate to focus on this molecule in non-granulomatous anterior uveitis and non-severe recurrent scleritis.     

Colchicine: A potential therapeutic tool against COVID-19. Experience of 5 patients

COVID-19 is a newly emerged disease that has become a global public health challenge. Due to a lack of knowledge about the virus, a significant number of potential targets for using a particular drug have been proposed. Five cases with a clinical history of biopolymers in the gluteal region that developed iatrogenic allogenosis (IA) are presented here. The 5 cases were put under colchicine treatment for IA crisis and had non-specific symptoms (headache, cough without dyspnea, and arthralgias) with a positive SARS-CoV-2 test. Their close contacts had mild to severe symptoms and three of them died. In the SARS-CoV-2 infection different inflammatory pathways are altered where colchicine reduces cytokine levels as well as the activation of macrophages, neutrophils, and the inflammasome. The possible mechanisms that colchicine may use to prevent acute respiratory distress syndrome (ARDS) in patients with COVID-19 infection are also reviewed in this article.     

银杏叶提取物与秋水仙碱对大鼠肝纤维化预防作用的比较

目的比较银杏叶提取物(GBE)和秋水仙碱对实验性大鼠肝纤维化的预防作用。方法SD雄性大鼠40只随机分为4组:正常组(n=10)、模型组(n=10)、秋水仙碱预防组(n=10)及GBE预防组(n=10)。模型组、秋水仙碱预防组及GBE预防组给予500 mL/L CCl4腹腔注射,1 mL/kg,每周2次,共8周,秋水仙碱预防组每天同时给予秋水仙碱灌胃,0.2 mg/kg,GBE预防组每天同时给予GBE灌胃,0.3 g/kg。实验结束后,心脏取血分离血清行肝功能生化指标检测,处死动物取肝脏甲醛固定,常规行HE染色,免疫组化检测α-SMA和TGF-β1。结果光镜下组织学检查纤维化分级GBE预防组低于秋水仙碱预防组(P0.05),肝功能生化指标检测GBE预防组优于秋水仙碱预防组[ALT:(168.4±34.6)U/Lvs(210.6±40.8)U/L;AST:(318.8±62.5)U/Lvs(511.2±53.2)U/L;ALB:(31.0±2.1)g/Lvs(28.1±2.0)g/L;P均0.05],免疫组化检测α-SMA及TGF-β1蛋白表达GBE预防组低于秋水仙碱预防组(α-SMA:29.3±1.5vs5.1±2.2;TGF-β1:14.5±0.9vs28.6±0.9)。结论GBE预防大鼠肝纤维化的作用优于秋水仙碱,GBE作为一种新的抗肝纤维化药物有很好的研究和应用前景。     

Evidence-based recommendations for the practical management of Familial Mediterranean Fever

Aim

Familial Mediterranean Fever (FMF) is the most common recurrent autoinflammatory fever syndrome. Still, many issues—e.g.: colchicine dosage adjustment, maximum dosage of colchicine in children and adults, definition of colchicine resistance, alternative treatment solutions in colchicine-resistant patients, and genetic screening for asymptomatic siblings—have not yet been standardized. The current paper aims at summarizing consensus recommendations to approach these issues.

Methods

A literature review concerning these practical management questions was performed through PubMed. On the basis of this analysis, expert recommendations were developed during a consensus meeting of caregivers from France and Israel.

Results

A patient experiencing more than four FMF attacks a year needs colchicine dose adjustment. In case of persistent attacks (≥6 per year) in patients with maximum doses of colchicine (2 mg in children; 3 mg in adults), alternative treatment to colchicine with IL1 inhibitors should be considered. Routine genetic testing for MEFV mutations in asymptomatic siblings of an index case is not recommended.

Conclusion

This is a first attempt to resolve practical questions in the daily management of FMF patients.