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COLCHICINE OF POSSIBLE BENEFIT IN CIRRHOSIS.

Once cirrhosis starts, no treatment reliably reverses the process. This study from Mexico suggests that the use of long-term oral colchicine may be a promising treatment. One hundred patients with cirrhosis (confirmed histologically in 92 percent) were entered into a prospective, double-blind, randomized trial, and followed for a mean period of 4.7 years (up to 14 years).

The colchicine group had markedly better median survival times than the placebo group (11 versus 3.5 years, respectively). Of the patients who underwent repeat biopsies, one-third of 30 colchicine-treated patients showed histologic improvement, whereas none of the 14 placebo- treated patients showed any improvement. The treatment caused few side effects.

Animal experiments support the tentative conclusion that colchicine may retard or reverse hepatic fibrosis. Also lending strength to this study's conclusions is its exceptionally long follow-up period. At the same time, however, the study is weakened by a lack of detail regarding patients' diets and alcohol use, the possibility that sicker patients were (by chance) included in the placebo group, a lack of information about causes of death, and the loss to follow-up of a relatively large fraction of patients (20 percent). Additional studies are needed before widespread use of colchicine can be recommended.

— ALK

Published in Journal Watch General Medicine July 12, 1988

Citation(s):

Boyer J L; Ransohoff D F. Is colchicine effective therapy for cirrhosis?. N Engl J Med 1988 Jun 30 318 1751-1752.

• Medline abstract (Free)

Kershenobich D; Vargas A; Garcia Tsao G; Tamayo R P; Gent M; Rojkind M. Colchicine in the treatment of cirrhosis of the liver. N Engl J Med 1988 Jun 30 318 1709-1713.

• Medline abstract (Free)