Standard practice is to add colchicine to allopurinol in first 6 months of gout treatment. Allopurinol treatment dissolves crystals of uric acid which can irritate tissues in that process. ” Subjects treated with colchicine experienced fewer total flares (0.52 vs 2.91, p = 0.008), fewer flares from 0 to 3 months (0.57 vs 1.91, p = 0.022), fewer flares 3–6 months (0 vs 1.05, p = 0.033), less severe flares as reported on VAS (3.64 vs 5.08, p =0.018), and fewer recurrent gout flares (p = 0.001). Colchicine was well tolerated.”
Borstad, Gregory C., et al.
Colchicine for prophylaxis of acute flares when initiating allopurinol for chronic gouty arthritis.
The Journal of rheumatology 31.12 (2004): 2429-2432
- 45 cases
- “dose of allopurinol was increased in 100 mg increments until a serum urate level of < 6.5 mg/dl [387 umol/l] was attained. In the setting of chronic renal insufficiency (defined as a creatinine clearance of 20–50 ml/min), the dose was escalated in 50 mg increments. “
- colchicine 0.6 mg bid
Comment – an oldy but nice to know it is acceptable treatment. Those with associated osteoarthritis might benefit from use of an NSAID. instead.