Relation of Colchicine to Total Joint Arthroplasty Among People With Gout in a Population-Based Cohort Study

To evaluate the relation of colchicine use to the risk of total joint arthroplasty (TJA) in individuals with gout, the most common form of arthritis for which colchicine is prescribed.

This new-user design, time-stratified, population-based cohort study used a UK primary care database (2000-2021). We identified participants with gout who were newly prescribed colchicine after their gout diagnosis. Each colchicine initiator was propensity score matched with a noninitiator using one-year cohort accrual blocks. The effect of colchicine on the risk of TJA was assessed using Cox proportional hazard regression. Analyses were repeated and limited to participants with both gout and knee/hip osteoarthritis (OA).

We identified 31,478 colchicine initiators who were propensity score matched to an equal number of noninitiators (mean age 60 years, mean body mass index 30), with a median follow-up time of 4.5 years. Colchicine initiators had a 12% lower risk of TJA than noninitiators (hazard ratio [HR] 0.88, 95% confidence interval [CI] 0.81-0.96), which remained similar after additional adjustment for confounders (HR 0.89, 95% CI 0.82-0.97). Colchicine initiators with gout had a 23% lower risk of TJA among those with knee/hip OA (HR 0.77, 95% CI 0.64-0.92) compared with noninitiators (HR 0.77, 95% CI 0.64-0.92).

In this large population-based cohort of people with gout, colchicine initiation was associated with a modestly lower risk of TJA. Colchicine may offer a long-term benefit in reducing the risk of joint arthroplasty in individuals with gout and knee or hip OA.