2023-06-02 15:36:37
Patients with osteoarthritis have painful and stiff joints. Current treatment options are painkillers or major joint replacement surgery. Research by the Radboudumc in Nijmegen and the Sint Maartenskliniek now shows that colchicine, an age-old remedy for gout, is probably effective against osteoarthritis.
About one and a half million Dutch people suffer from osteoarthritis. The cartilage of one or more joints is damaged, the bone under the cartilage changes and joints are often inflamed. Osteoarthritis is painful and severely restricts patients’ freedom of movement. The only treatment options are painkillers and major joint replacement surgery. That may be about to change. Investigation of the Sint Maartens Clinic and the Radboudumc provides strong evidence that an age-old remedy for gout is also effective against osteoarthritis.
Colchicine. It concerns the medicine colchicine, which has been used against gout since the first century AD. It inhibits the inflammation in this condition. Years ago, Professor of Cardiology Jan Hein Cornel of Radboud university medical center and colleagues came up with the idea that this drug could work against cardiovascular diseases. Cornel explains: ‘Inflammation also plays an important role there. And we were right: in our study of more than 5,000 cardiovascular patients, colchicine reduced the risk of a heart attack, angioplasty, bypass or stroke by 30%.’
(Bron Wikipedia – 2023)
Picture of a healthy knee (left) and an osteoarthritis-affected knee (right)
Rheumatologist Calin Popa of the Sint Maartens Clinic was impressed by these results and thought: maybe this drug also inhibits the inflammation in osteoarthritis. He contacted Cornel, who was immediately enthusiastic, and together they made a plan. They wanted to find out how many of the cardiovascular patients in the colchicine study had had a new knee or hip.
Safe and cheap. Michelle Heijman, researcher at the Sint Maartenskliniek, conducted the research. ‘The drug does indeed seem to work against osteoarthritis. The number of patients with a knee or hip replacement was more than 30% lower in the group treated with colchicine than in the placebo group. Because it’s such an old drug, we know it’s safe. And the treatment is easy: one tablet once a day, prescribed by the GP.’ Popa also sees a promising future for colchicine as an osteoarthritis treatment: ‘There are other drugs that also seem to have an effect against osteoarthritis, but they are either less safe or very expensive. Colchicine only costs a few tenners a year. Because osteoarthritis is so common, the cost savings can be enormous.’
Follow-up research. Patients with osteoarthritis cannot yet be treated with colchicine. Because the study used data from a study of cardiovascular patients, doctors cannot yet prescribe the drug for osteoarthritis. That is why Popa and Cornel want to conduct follow-up research specifically aimed at osteoarthritis.
‘If we can confirm that colchicine works, that’s fantastic news.” says Popa. ‘We will finally be able to offer osteoarthritis patients a safe and effective remedy. This greatly improves their quality of life and in some cases could postpone or even prevent major surgery. That saves healthcare costs. In short: a win-win-win situation.’
About the publication. This research was published in the Annals of Internal Medicine: Association of Low-Dose Colchicine With Incidence of Knee and Hip Replacements. MWJ Heijman, ATL Fiolet, A. Mosterd, JGP Tijssen, BJF van den Bemt, A. Schut, JW Eikelboom, PL Thompson, CHM van den Ende, SM Nidorf, CD Popa, JH Cornel. DOI: 10.7326/M23-0289 Are you a patient with osteoarthritis and are you looking for more information about colchicine and the follow-up study? Then click here to be redirected to the Sint Maartenskliniek page on this subject.
Arthrosis Osteoarthritis (OA) is a type of degenerative joint disease resulting from the breakdown of articular cartilage and underlying bone, affecting 1 in 7 adults in the United States. It is believed to be the fourth leading cause of disability in the world. The most common symptoms are joint pain and stiffness. Usually the symptoms progress slowly over the years.
Other symptoms may include joint swelling, decreased range of motion, and, when the back is affected, weakness or numbness of the arms and legs. The joints most commonly involved are the two near the tips of the fingers and the joint at the base of the thumbs, the knee and hip joints, and the joints of the neck and lower back. The symptoms can interfere with work and normal daily activities. Unlike some other types of arthritis, only the joints are affected, not the internal organs.
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