Disclosure(s): No financial relationships with ineligible companies to disclose
Background/Purpose: Osteoarthritis (OA) is the most common joint disease, that leads to significant pain and affects quality of life, particularly in older adults. Current treatments primarily focus on symptom relief, as no treatment has yet demonstrated the ability to modify disease progression or restore damaged joint structures. Colchicine, a medication traditionally used to treat gout, has attracted interest as a potential therapy for OA due to its anti-inflammatory effects. Despite growing interest, the evidence regarding colchicine efficacy and safety in OA management remains inconclusive. This study aims to assess the safety and efficacy of colchicine in treating OA. Methods: We conducted a systematic search across multiple databases, such as PubMed, Web of Science, and Scopus from inception till April 5th, 2025. We included randomized clinical trials evaluating the efficacy and safety of colchicine in OA (Fig 1). The main outcome was pain measured by visual analogue scale (VAS). We stratified the outcome into three follow-up intervals: short-term (4 and 8 weeks), medium-term (10, 12 and 16 weeks), and long-term (20 and 24 weeks or longer). We used Rayyan for identifying duplicates, title, abstract and full-text screening and Review Manager (RevMan) software Version 5.4 for meta-analysis. Results: This systematic review and meta-analysis incorporates data from a total of 21 clinical trials encompassing 6,965 participants, with 13 contributing to the meta-analysis including 879 participants. The main objective was to assess the efficacy of colchicine across multiple outcome measures. Pain relief, assessed by VAS, exhibited a significant short-term improvement at week 8 (standardized mean difference [SMD] = -1.03, 95% confidence interval [CI]: -2.01, -0.06, p=0.04), and a non-significant improvement at medium-term follow-up at week 12 (SMD = -0.34, 95% CI: -0.78, 0.10, p=0.75), and a significant long-term improvement at week 20 follow-up (SMD = -1.24, 95% CI: -1.73, -0.76, p< 0.00001), with an overall significant improvement (SMD = -0.73, 95% CI:-1.06, -0.41, p < 0.00001) (Fig 2). Similarly, quality of life indicated significant impact of colchicine treatment (SMD = -0.48, 95% CI: -0.83, -0.12, p =0.008). However, for physical dysfunction, the analysis reveals no statistically significant difference (SMD = -0.21, 95% CI: -0.45, 0.04, p=0.09), with significant difference in adverse events (AEs) (risk ratio [RR]: 1.27; 95% CI:1.07, 1.50, p=0.007) between colchicine and control groups (Fig 3). Conclusion: This is the most recent and comprehensive systematic review and meta-analysis showing that colchicine is an effective therapeutic option for OA, with significant pain relief measured by VAS score. Additionally, it contributes to improved quality of life in patients with OA. However, physical dysfunction did not show significant differences. Future research should focus on optimal dosing, long-term safety, and larger randomized controlled trials to validate these findings.
