Osteoarthritis is one of the most common joint diseases in the world, especially among older adults.
New research suggests that a small daily dose of an inexpensive medicine called colchicine may be linked to a lower chance of needing knee or hip replacement surgery.
Osteoarthritis develops when the tissues inside a joint gradually become damaged. Cartilage, the smooth tissue that helps bones move easily against each other, can break down, while changes can also occur in the bone and other tissues around the joint.
This can cause pain, stiffness, swelling and difficulty moving. The knees and hips are commonly affected, and severe disease can eventually make walking, climbing stairs and other everyday activities difficult.
Doctors can help control symptoms with exercise, weight management, physical therapy and pain medicines. However, there is currently no simple medicine that reliably stops osteoarthritis from getting worse, and people with severe joint damage may eventually need replacement surgery.
Researchers have therefore been looking at inflammation as a possible treatment target. Although osteoarthritis was once viewed mainly as simple “wear and tear,” scientists now know that low-level inflammation can also contribute to joint damage in some people.
Colchicine is an old anti-inflammatory medicine best known as a treatment for gout. It is also used for some other inflammatory conditions, and researchers have wondered whether its ability to reduce inflammation might offer benefits for damaged joints.
In the study, researchers from Sint Maartenskliniek and Radboud University Medical Center in the Netherlands worked with investigators at 43 medical centers in Australia and the Netherlands. Their analysis included 5,522 adults between the ages of 35 and 82.
Participants were assigned to receive either 0.5 milligrams of colchicine each day or a placebo with no active medicine. They were followed for about two and a half years.
During that period, 2.5% of people assigned to colchicine underwent a knee or hip replacement, compared with 3.5% of those assigned to the placebo. In absolute terms, that was a difference of about one percentage point.
That difference may appear modest, but joint replacement is a major operation and is performed in large numbers of people. If the effect is confirmed in future studies, even a small reduction in surgery rates could potentially matter at the population level.
The apparent benefit was particularly noticeable among men. However, the researchers did not have enough evidence to determine clearly whether women would receive the same benefit, so further research involving a more balanced population is needed.
The findings were published in the Annals of Internal Medicine. The research raises the possibility that an existing, relatively inexpensive medicine could eventually be repurposed to help some people with osteoarthritis.
There are important reasons for caution, however. The study does not mean that colchicine is now a standard treatment for osteoarthritis, and more research is needed to determine whether it truly slows joint damage and which patients are most likely to benefit.
Colchicine can also cause side effects and may interact with other medicines. It can be dangerous at excessive doses or in certain people, including some patients with kidney or liver problems, so it should only be used under appropriate medical supervision.
Researchers will also need to study the effects of taking the medicine for longer periods. Osteoarthritis can develop over many years, which means a treatment designed to delay surgery would need to remain both effective and acceptably safe over time.
The discovery is nevertheless encouraging because osteoarthritis is becoming a larger health challenge as populations age. Joint replacements can greatly improve quality of life when they are needed, but preventing or safely delaying surgery would give patients another valuable option.
For now, people with osteoarthritis should not start taking colchicine specifically to protect their joints unless a healthcare professional recommends it for an appropriate reason. Future trials should help determine whether this familiar medicine can become part of a new approach to slowing osteoarthritis and reducing the need for major joint surgery.
If you care about pain, please read studies about vitamin K deficiency linked to hip fractures in old people, and these vitamins could help reduce bone fracture risk.
For more health information, please see recent studies that Krill oil could improve muscle health in older people, and eating yogurt linked to lower frailty in older people.
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