It is IRF's overall assessment that colchicine may be considered relevant for treatment of acute gout and in connection with initiation of or dose adjustments in urate-lowering treatment. At the recommended dose, the risk profile compares to placebo. However, colchicine has been investigated in very few studies only and never against relevant comparators such as NSAIDs (1) and prednisolone. The choice of treatment should therefore primarily be made on the basis of patient factors and price.
Colchicine was marketed for the first time on 13 April 2015, and it can therefore no longer be prescribed as a magistral preparation without approval from the Danish Medicines Agency (2). The treatment is not eligible for general reimbursement (3), but prescribers may apply for single reimbursement on behalf of eligible patients, e.g. those with heart disease or similar conditions for whom NSAIDs may be contraindicated.
1. van Durme CM, Wechalekar MD, Buchbinder R, Schlesinger N, van der Heijde D, Landewe RB. Non-steroidal anti-inflammatory drugs for acute gout. The Cochrane database of systematic reviews. 2014;9:Cd010120.
2. IRF. Available from: http://www.irf.dk/dk/publikationer/rationel_farmakoterapi/maanedsblad/2015/off-label-magistrelle-og-udleveringstilladelser.htm.
3. Sundhedsstyrelsen. 2016. Available from: http://laegemiddelstyrelsen.dk/da/tilskud/generelle-tilskud/afgoerelser#.