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The Role of Colchicine in Different Clinical Phenotypes of Behcet Disease
Zeyuan Wang1, Xiaoman Zu2, Shanshan Xiong2
1Department of Gastroenterology, The First Affiliated Hospital, Sun Yat-sen University, Guangzhou, China; Department of Cardiology, Peking Union Medical College Hospital, Peking Union Medical College & Chinese Academy of Medical Sciences, Beijing, China.
Insights
Colchicine effectively treats skin, mucosal, and joint symptoms in Behcet disease (BD). Further research is needed to confirm its benefits and explore new applications for this ancient plant extract in managing BD.
Area of Science:
- Rheumatology
- Pharmacology
Background:
- Behcet disease (BD) is a multisystemic inflammatory disorder with diverse clinical presentations.
- Colchicine, a plant-derived alkaloid, is a first-line treatment for several inflammatory conditions.
Purpose of the Study:
- To review the current clinical applications of colchicine in managing Behcet disease.
- To summarize the efficacy of colchicine across various Behcet disease phenotypes.
Main Methods:
- A comprehensive literature search was conducted in PubMed, MEDLINE, and Cochrane Library.
- Searched terms included Behcet's disease, colchicine, treatment, and therapy from 1980 to March 2021.
Main Results:
- Colchicine demonstrates efficacy in treating mucocutaneous and joint manifestations of Behcet disease.
- The drug's anti-inflammatory, anti-mitotic, anti-tumor, and anti-fibrotic properties contribute to its therapeutic effects.
Conclusions:
- Colchicine can reduce symptom severity and potentially improve disease activity in Behcet disease patients.
- Further randomized clinical trials and mechanistic studies are essential to validate colchicine's role and uncover novel therapeutic uses.
Purpose:
Behcet disease (BD) is a multisystemic disorder characterized by variable clinical manifestations that affect nearly all systems and organs. Colchicine, an alkaloid plant extract, is considered as the first-line therapy for gout, pericarditis, and familial Mediterranean fever. However, the role of colchicine in the treatment of different clinical phenotypes of BD has not been clearly described. This narrative review summarizes the clinical use of colchicine in BD.
Methods:
All relevant literature from 1980 to March 2021 was searched in PubMed, MEDLINE, and Cochrane Library. The Medical Subject Heading terms and related words that were searched are as follows: Behcet's disease, Behcet's syndrome, BD, colchicine, management, treatment, and therapy.
Findings:
BD is an autoimmune systemic vasculitis with various clinical phenotypes, with involvement of skin mucosa, joints, eyes, and gastrointestinal, vascular, and neurologic systems. Colchicine has been used for centuries, acts by binding to tubulin to prevent the mitotic process, and has anti-inflammatory, antitumor, and antifibrotic properties. Colchicine has been reported to be an effective option for the treatment of skin, mucosal, and joint involvement in patients with certain BD clinical phenotypes.
Implications:
Colchicine reduces the severity of certain clinical phenotypes and may improve the overall disease activity index in patients with BD. More randomized clinical trials are needed to confirm the value of colchicine in the treatment of BD, and further elucidation of the mechanisms is also needed, which may reveal new application of colchicine that has been used for centuries.
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