Colchicine: New Insights to an Old Drug

Colchicine is an ancient drug that is used for symptomatic relief in a wide range of inflammatory diseases including gout, Behçet syndrome, and familial Mediterranean fever. Recognition of its antiinflammatory properties and of its unpleasant gastrointestinal side effects date back thousands of years. Despite this, uncertainty remains concerning its mechanism of action and very few randomized controlled trials have been carried out to examine its safety and efficacy to date. Although it is an effective drug, its use is hindered by a very narrow therapeutic index. This review attempts to summarize recent developments concerning the use of colchicine in the treatment of gout with particular focus on its mechanism of action and toxicity.