Systematic review of colchicine neuromyopathy: Risk factors, duration and resolution
Authors' conclusion
Neuromyopathy is an uncommon but reported adverse effect of colchicine. Cases generally present with proximal myopathy symptoms. Cases of colchicine neuromyopathy are largely reported in patients on commonly used doses. Renal and hepatic dysfunction and medications that inhibit cytochrome P450 3A4 isozyme (CYP3A4) and P-glycoprotein (P-gp) appear to be the most significant risk factors. Fortunately, cessation of colchicine generally leads to complete resolution of symptoms.
Study context
- Population
- Case reports of neuropathy and/or myopathy associated with colchicine at therapeutic doses99 articles
- Participants
- 143 participants
- Outcome
- Colchicine neuromyopathy: presentation and risk factors
Methodological detailsPRISMA methodology, PubMed and EMBASE searched through October 2021, causality assessed by the Naranjo algorithm
- PRISMA methodology
- PubMed and EMBASE searched through October 2021
- Causality assessed by the Naranjo algorithm
Pooled result
As reported in the abstract
- Features of both neuropathy and myopathy (myopathy symptoms predominant)
- n=72, 51%
- Mean total daily dose
- 1.25±0.60 mg
- Taking colchicine >12 months before presentation
- 48%
- Significant co-morbidity or possible colchicine drug-drug interaction
- 117 (82%)
- Both risk factors
- 57 (40%)
- No significant risk factor
- 26 cases (18%)
Further pooled results
Resolution after cessation of colchicine
- Complete resolution of symptoms
- 70%
- Median time to resolution
- 21 days
Recurrence after restarting colchicine at reduced doses
- Cases restarted at reduced doses
- 15
- No symptom recurrence
- 73%
Deaths
- Deaths due to multi-organ failure despite cessation of colchicine and medical management
- 3
Original publication
Systematic review of colchicine neuromyopathy: Risk factors, duration and resolution. Semin Arthritis Rheum. Published 8 December 2022. doi:10.
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