Colchicine use is associated with lower likelihood of chronic kidney disease (CKD) progression, a new Korean study finds.
Investigators performed a case-control study of patients treated with hyperuricemia or gout drugs (ie, allopurinol, febuxostat, and colchicine) who had a baseline estimated glomerular filtration rate (eGFR) of 15 to 59 mL/min/1.73 m2. They matched 3085 patients who experienced CKD progression (a 40% or greater decrease in eGFR or kidney failure) to 11,715 patients without progression. The median follow-up time was 2.4 years.
A multivariate conditional logistic regression analysis showed that patients with 90 or more cumulative daily colchicine doses had significant 23% lower adjusted odds of progression compared with never users, Seung Hyeok Han, MD, PhD, of Yonsei University’s Institute of Kidney Disease Research in Seoul, Korea, and colleagues reported in Rheumatology. In subgroup analyses, the investigators found significant associations between colchicine use and reduced CKD progression only among patients with stage 3 CKD and without diabetes or hypertension. The probability of CKD progression was not affected by use of allopurinol or febuxostat.
“Our findings warrant well-designed [randomized controlled trials] in the future to test the potential renoprotective effects of colchicine in CKD patients,” according to Dr Han’s team, including finding an optimal dose.
Colchicine interferes with microtubule polymerization and neutrophil function and has anti-inflammatory and anti-fibrotic effects, they noted.
Kim HW, Joo YS, Yun HR, et al. Colchicine use and the risk of CKD progression: A multicenter nested case-control study. Rheumatology. Published online February 9, 2022. doi:10.1093/rheumatology/keac077