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Meta-Analysis
. 2024 Dec 30;19(12):e0316126.
doi: 10.1371/journal.pone.0316126. eCollection 2024.

Colchicine combination therapy increases treatment tolerance in patients with arthritis: A systematic review and meta-analysis

Changwei Zhao  1   2 , Xiaogang Hao  2 , Wenjun Cai  3 , Ling-Feng Zeng  4 , Wenhai Zhao  2 , Xiangxin Li  2
Affiliations
Meta-Analysis

Colchicine combination therapy increases treatment tolerance in patients with arthritis: A systematic review and meta-analysis

Changwei Zhao et al. PLoS One. .

Abstract

Background: Arthritis seriously affects people's quality of life, and there is an urgent clinical need to improve the efficacy of medications as well as to reduce the adverse effects induced by treatment. Combined colchicine therapy is gradually being embraced in clinical care, but the evidence remains insufficient.

Methods: English databases were searched from the establishment to September 4, 2024. Eleven eligible Randomized controlled trials (RCTs) were included. The quality of the literature was assessed by the risk of bias tool in the Cochrane Handbook. Relative risk (RR) and Cohen's d (SMD) were used for categorical and continuous variables, respectively, at 95% confidence interval (CI), and Stata 17.0 software was used for statistical analysis. Sensitivity analyses were used to verify the stability of the analyzed results, and heterogeneity analyses were used to explore the sources of heterogeneity in the studies. Funnel plots and Egger's test were used to assess publication bias.

Results: Eleven eligible RCTs were included in this study. Compared with conventional treatment, combined colchicine treatment improved patient's global assessment results (SMD = 1.24, 95% CI [0.01, 2.47], P = 0.05, I2 = 0]), stiffness (SMD = -0.81, 95% CI [-1.43, -0.19], P = 0.01, I2 = 63.91%]) and did not increase adverse effects (RR = 0.79, 95% CI [0.31, 1.27], P = 0.36, I2 = 0.00%). However, combined colchicine treatment did not improve visual analog scores (VAS) (SMD = -0.96, 95% CI [-2.85, 0.93], P = 0.13, I2 = 97.99%]), Western Ontario and McMaster Universities Arthritis Index (WOMAC) pain (SMD = 0.01, 95% CI [-0.24, 0.27], P = 0.91, I2 = 0]), WOMAC function (SMD = -0.01, 95% CI [-0.36, 0.16], P = 0.44, I2 = 0]), Total WOMAC scale (SMD = -0.05, 95% CI [-0.33, 0.22], P = 0.70, I2 = 0]), physician 's global assessment (SMD = 0.36, 95% CI [-2.27, 3.00], P = 0.79, I2 = 97.04%]) and Modified Clinical Health Assessment Questionnaire (ModHAD) (SMD = -1.72, 95% CI [-4.90,1.45], P = 0.29, I2 = 99.11%]).

Conclusion: Compared with colchicine alone, combination therapy improves patients' quality of life without increasing the incidence of adverse events.

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Conflict of interest statement

The authors declare that they have no competing interests, 作者声明他们没有竞争利益.

Figures

Fig 1
Fig 1. Flowchart of study selection and identification.
Fig 2
Fig 2. The risk of bias of 11 RCTs.
Fig 3
Fig 3. Comparison of VAS score between the colchicine group and the non-colchicine group.
Fig 4
Fig 4. Comparison of WOMAC pain score between the colchicine group and the non-colchicine group.
Fig 5
Fig 5. Comparison of WOMAC function score between the colchicine group and the non-colchicine group.
Fig 6
Fig 6. Comparison of total WOMAC scale score between the colchicine group and the non-colchicine group.
Fig 7
Fig 7. Comparison of physician’s global assessment score between the colchicine group and the non-colchicine group.
Fig 8
Fig 8. Comparison of patient’s global assessment score between the colchicine group and the non-colchicine group.
Fig 9
Fig 9. Comparison of ModHAQ score between the colchicine group and the non-colchicine group.
Fig 10
Fig 10. Comparison of stiffness between the colchicine group and the non-colchicine group.
Fig 11
Fig 11. Comparison of adverse events between the colchicine group and the non-colchicine group.
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