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Wiley InterScience | ||
  The American Journal of GastroenterologyVolume 100 Issue 8, Pages 1876 - 1885 Published Online: 14 Jul 2005 © 2008 American College of Gastroenterology/Blackwell Publishing Official publication of the American College of Gastroenterology
Abstract | References | Full Text: HTML, PDF (Size: 393K) | Related Articles | Citation Tracking  Colchicine for Primary Biliary Cirrhosis: A Cochrane Hepato-Biliary Group Systematic Review of Randomized Clinical Trials Copyright 2005 by the American College of Gastroenterology (Am J Gastroenterol 2005;100:1876–1885) ABSTRACTOBJECTIVES: Colchicine is used for patients with primary biliary cirrhosis due to its immunomodulatory and antifibrotic potential. The results from randomized clinical trials have, however, been inconsistent. We conducted a systematical review to evaluate the effect of colchicine for primary biliary cirrhosis. METHODS: We identified randomized clinical trials comparing colchicine with placebo/no intervention. We analyzed effects by fixed and random effects model. We investigated heterogeneity by subgroup and sensitivity analyses. RESULTS: We included 10 trials involving 631 patients, four of which were high-quality trials. No significant differences were detected between colchicine and placebo/no intervention regarding mortality (relative risk (RR), 1.21; 95% confidence interval (CI), 0.71–2.06), mortality or liver transplantation (RR = 1.00; 95% CI, 0.67–1.49), liver complications, liver biochemical variables, liver histology, or adverse events. Regarding mortality, an extreme case analysis favoring colchicine did not demonstrate beneficial effects of colchicine, whereas an extreme case analysis favoring placebo/no intervention demonstrated a detrimental effect of colchicine (RR = 2.28; 95% CI, 1.17–4.44). The number of patients without improvement of pruritus significantly decreased in the colchicine group (RR = 0.75; 95% CI, 0.65–0.87). However, this estimate was based on only 156 patients from three trials. CONCLUSIONS: There is insufficient evidence to support the use of colchicine for patients with primary biliary cirrhosis. As we are unable to exclude a risk of increased mortality, we recommend to use colchicine only in randomized clinical trials. Received September 15, 2004; accepted February 28 2005. |  |
