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Colchicine myopathy in renal transplant recipients on cyclosporin
D Ducloux1, V Schuller, C Bresson-Vautrin
1Department of Nephrology and Renal Transplantation, Hospital Saint Jacques, Besançon, France.
Abstract:
Few data are available about the muscle status in renal transplant recipients. Moreover, the list of myotoxic drugs is growing longer and some of them are likely to be prescribed in renal transplant patients. These conditions may act as confounding factors in case reports of both cyclosporin and colchicine myopathies. Moreover no study has evaluated the frequency of myopathy in patients on both colchicine and cyclosporin. We conducted a retrospective study including all renal transplant recipients followed in our unit in whom colchicine was prescribed since January 1994. Clinical and biological data of patients on both colchicine and cyclosporin were analysed. Secondly case subjects were compared with matched controls not receiving colchicine but cyclosporin. Ten patients received colchicine in association with cyclosporin. Five patients (50%) experienced muscular symptoms and when performed, muscular histology showed vacuolar myopathy. All five patients improved after colchicine withdrawal. Cases with and without muscular symptoms did not differ in age, transplant duration, and serum creatinine level. Mean duration of colchicine therapy was 12.2 +/- 4.4 months in cases with muscular symptoms and 6.8 +/- 4.6 months in cases without muscular symptoms (P < 0.05). No control complained of either muscular pain nor weakness (P < 0.0005). Only one patient (3.3%) had elevated serum creatine phosphokinase concentration (P < 0.0005). We conclude that myopathy is very frequent in patient on both colchicine and cyclosporin. Muscular symptoms improve in all patients after colchicine withdrawal.
Insights
Myopathy is common in renal transplant patients taking both colchicine and cyclosporin. Muscle symptoms occurred in 50% of patients and resolved after discontinuing colchicine, indicating its myotoxic potential.
Area of Science:
- Nephrology
- Neurology
- Pharmacology
Background:
- Limited data exist on muscle health in renal transplant recipients.
- Myotoxic drug use is increasing, posing risks for transplant patients.
- Confounding factors can complicate the diagnosis of drug-induced myopathies.
Purpose of the Study:
- To evaluate the frequency of myopathy in renal transplant recipients using both colchicine and cyclosporin.
- To analyze clinical and biological data of patients on this drug combination.
- To compare patients with myopathy to matched controls on cyclosporin alone.
Main Methods:
- Retrospective study of renal transplant recipients prescribed colchicine since January 1994.
- Analysis of clinical and biological data, including muscular histology.
- Comparison of case subjects (colchicine + cyclosporin) with matched controls (cyclosporin only).
Main Results:
- Ten patients received colchicine with cyclosporin; 50% (5/10) developed muscular symptoms (vacuolar myopathy).
- All affected patients improved after colchicine withdrawal.
- Patients with myopathy had a longer mean colchicine therapy duration (12.2 months vs. 6.8 months).
- No controls reported muscle pain or weakness; elevated creatine phosphokinase was rare (3.3%).
Conclusions:
- Myopathy is highly prevalent in renal transplant recipients treated with both colchicine and cyclosporin.
- Colchicine is a significant contributor to myopathy in this patient population.
- Discontinuation of colchicine leads to symptom resolution.