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Meta-Analysis
. 2005 Apr 18;2005(2):CD002148.
doi: 10.1002/14651858.CD002148.pub2.

Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis

A Rambaldi  1 , C Gluud
Affiliations
Meta-Analysis

Colchicine for alcoholic and non-alcoholic liver fibrosis and cirrhosis

A Rambaldi et al. Cochrane Database Syst Rev. .

Abstract

Background: Alcohol and hepatotropic viruses cause the majority of liver cirrhosis cases in the Western World. Colchicine is an anti-inflammatory and anti-fibrotic medication. Several randomised clinical trials have addressed the question whether colchicine has any efficacy in patients with alcoholic or non-alcoholic fibrosis and cirrhosis.

Objectives: To assess the beneficial and harmful effects of colchicine in patients with alcoholic or non-alcoholic fibrosis or cirrhosis, excluding primary biliary cirrhosis.

Search strategy: The Cochrane Hepato-Biliary Group Controlled Trials Register, The Cochrane Controlled Trials Register on The Cochrane Library, MEDLINE, EMBASE, Web of Science, and full text searches were combined (September 2004). Manufacturers and researchers in the field were also contacted.

Selection criteria: We included randomised trials irrespective of blinding, language, or publication status comparing per oral colchicine with placebo or no intervention for patients with fibrosis or cirrhosis induced by either alcohol, virus, or unknown factors (cryptogenic).

Data collection and analysis: The statistical package (RevMan Analyses) provided by The Cochrane Collaboration was used. The methodological quality of the randomised clinical trials was evaluated.

Main results: We could include fifteen randomised clinical trials in which 1714 patients were randomised. We found no significant effects of colchicine on mortality (relative risks (RR) 1.00, 95% confidence interval (CI) 0.87 to 1.16), liver-related mortality (RR 1.08, 95% CI 0.88 to 1.33), complications (RR 1.01, 95% CI 0.74 to 1.38), liver biochemistry, liver histology, and alcohol consumption (RR 1.03, 95% CI 0.77 to 1.39). Colchicine was associated with a significantly increased risk of adverse events (RR 4.35, 95% CI 2.16 to 8.77).

Authors' conclusions: Colchicine should not be used for alcoholic, viral, or cryptogenic liver fibrosis or liver cirrhosis outside randomised clinical trials.

PubMed Disclaimer

Conflict of interest statement

None known.

Figures

1
1
Search results
2
2
3
3
1.1
1.1. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 1 Mortality.
1.2
1.2. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 2 Liver‐related mortality.
1.3
1.3. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 3 Ascites.
1.4
1.4. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 4 Variceal bleeding.
1.5
1.5. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 5 Hepatic encephalopathy.
1.6
1.6. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 6 Hepato‐renal syndrome.
1.7
1.7. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 7 Total number of complications (variceal bleeding, hepatic encephalopathy, ascites, hepatorenal‐syndrome).
1.8
1.8. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 8 Bilirubin (mg/dl).
1.9
1.9. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 9 AST (U/l).
1.10
1.10. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 10 ALT (U/l).
1.11
1.11. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 11 ALP (U/l).
1.12
1.12. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 12 GGT (U/l).
1.13
1.13. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 13 Serum albumin (g/dl).
1.14
1.14. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 14 Prothrombin (%).
1.15
1.15. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 15 Prothrombin (seconds).
1.16
1.16. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 16 White blood count (1.000 cells/ cubic mm).
1.17
1.17. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 17 Collagen‐peptidase.
1.18
1.18. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 18 7S collagen (ng/ml).
1.19
1.19. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 19 Prolidase (U/l).
1.20
1.20. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 20 PIIIP (ng/ml).
1.21
1.21. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 21 Liver biopsy improvement.
1.22
1.22. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 22 Liver biopsy findings (hepatitis).
1.23
1.23. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 23 Liver biopsy findings (fibrosis).
1.24
1.24. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 24 Alcohol consumption.
1.25
1.25. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 25 Sustained biochemical response.
1.26
1.26. Analysis
Comparison 1 Colchicine versus placebo or no intervention, Outcome 26 Sustained virological response.
2.1
2.1. Analysis
Comparison 2 Adverse events, Outcome 1 Serious adverse events.
2.2
2.2. Analysis
Comparison 2 Adverse events, Outcome 2 Non‐serious adverse events.
3.1
3.1. Analysis
Comparison 3 Sensitivity analyses, Outcome 1 Mortality and duration of treatment.
3.2
3.2. Analysis
Comparison 3 Sensitivity analyses, Outcome 2 Mortality ‐ worst case scenario.
3.3
3.3. Analysis
Comparison 3 Sensitivity analyses, Outcome 3 Colchicine versus placebo or no intervention.
3.4
3.4. Analysis
Comparison 3 Sensitivity analyses, Outcome 4 Mortality and methodological quality.
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Update of

References

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MeSH terms