The Study
Is colchicine prophylaxis required with start-low go-slow allopurinol dose escalation in gout? A non-inferiority randomised double-blind placebo-controlled trial
This study gave people either a real medicine or a sugar pill while starting a new gout drug, then counted how many flare-ups they had. Because they randomly picked who got what, we can guess that the medicine probably caused the reduction in flares — but we don’t know all the details, so we can’t be 100% sure.
Analysis score
Maximum 90 for a randomized controlled trial.
Where the score came from
When people with gout start taking allopurinol to lower uric acid, they often get painful flares. This study tested if taking a tiny daily dose of colchicine for 6 months helps prevent those flares better than a sugar pill.
Where does this study sit?
Reviews of RCTs (Meta-analyses)
Max 100Randomized Trials
Max 90Reviews of Cohort Studies
Max 85Cohort Studies
Max 72Reviews of Case-Control Studies
Max 63Case-Control Studies
Max 58Cross-Sectional & Case Series
Max 50Expert Opinion
Max 571 / 100
Quality score
Participants are randomly assigned to treatment or control groups, minimizing bias. The gold standard for testing whether an intervention causes an effect.
Key takeaways
Summary
Based on the study abstract and findings.
- 1Yes — colchicine cut flares by nearly half during the first 6 months, but the benefit disappeared after stopping it, and it came with more serious side effects.
- 2With colchicine: 0.35 flares/month.
- 3With placebo: 0.61 flares/month.
- 4After stopping colchicine, both groups had the same number of flares (about 0.5 per month).
- 5Colchicine caused more serious side effects (11 events in 7 people) than placebo (3 events in 2 people).
Score breakdown, methodology, conflicts of interest, evidence analysis & raw study data
Publication
Journal
Annals of the Rheumatic Diseases
Year
2023
Authors
L. Stamp, A. Horne, B. Mihov, J. Drake, J. Haslett, P. Chapman, C. Frampton, N. Dalbeth
Related Content
Claims (4)
Patients who stopped taking colchicine after six months had the same number of gout flares per month as those who took a placebo, over a 12-month period.
Adults with gout who start allopurinol and take colchicine to prevent flares have more serious side effects in the first six months than those who take a placebo.
For adults starting allopurinol to treat gout, taking 0.5 mg of colchicine daily for six months lowers the average number of gout flares per month from 0.61 to 0.35 compared to taking no colchicine.
Starting allopurinol at a low dose along with anti-inflammatory medication lowers the chance of acute gout flares when lowering uric acid levels.
Not medical advice. For informational purposes only. Always consult a qualified healthcare professional before making health decisions.