Clinical Study on Colchicine Combined with Etofenamate Cream in the Treatment of Gout_West China Medical Journal

Authors：

 ZhouQiao , WuXiaodan , LongWubin ,  ZhouBin

Department of Rheumatology & Immunology, Sichuan Academy of Medical Sciences & Sichuan Provincial People's Hospital, Chengdu, Sichuan 610072, P. R. China;

Corresponding author：

ZhouBin, Email: bingb2917@126.com

Keywords：

Acute gouty arthritis; Colchicine; Etofenamate cream; Etoricoxib

DOI：

10.7507/1002-0179.201600129

Video：

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Objective To observe the efficacy and safety of colchicine combined with etofenamate cream in the treatment of acute gouty arthritis. Methods A total of 150 patients diagnosed with acute gouty arthritis from June 2013 to July 2014 were equally randomized to receive colchicine alone (group A), colchicine with etofenamate cream (group B) and colchicine with etoricoxib (group C). The assessment on joint pain, tenderness, health quality and clinical efficacy of patients in each group was carried out, and the results were compared before and 7 days after the treatment. Results Because of adverse events, the number of patients who withdrew from group A, B and C was respectively 2, 3 and 7. So the actual number of patients completing the study was 48 for group A, 47 for group B and 43 for group C. The patients' and physicians' assessments of mean change in pain intensity from baseline over days 1-7 were comparable in each group, with no statistical significance between groups (P>0.05). The patients' assessment of response to treatment was the highest in the colchicine with etofenamate cream group, and the differences compared with other two groups were significant (P=0.012 and 0.025, respectively). The physicians' global assessment of response to treatment showed no statistical significance between groups (F=0.021, P=0.908). The joint tenderness was most improved in colchicine with etoricoxib group, and the differences compared with other two groups were significant (P=0.041 and 0.034, respectively). The assessments of health quality were similar between groups. The C-reactive protein and erythrocyte sedimentation rate were decreased at study-end in all groups, but statistically significant differences were only found between group A and C (P<0.05). The incidence rate of adverse events was the highest in colchicine with etoricoxib group and the difference from other two groups was significant (P<0.05). Conclusion Colchicine with etofenamate cream is as effective as colchicine with etoricoxib for treating acute gout and may have a better safety and tolerability profile.

Citation： ZhouQiao, WuXiaodan, LongWubin, ZhouBin. Clinical Study on Colchicine Combined with Etofenamate Cream in the Treatment of Gout. West China Medical Journal, 2016, 31(3): 487-490. doi: 10.7507/1002-0179.201600129 Copy

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2.	Brook RA, Forsythe A, Smeeding JE, et al. Chronic gout:epidemiology, disease progression, treatment and disease burden[J]. Curr Med Res Opin, 2010, 26(12):2813-2821.
3.	Doherty M, New insights into the epidemiology of gout[J]. Rheumatology, 2009, 48(Suppl 2):ii2-ii8.
4.	Dinesh K, John DF, Puja PK, et al. 2012 American College of Rheumatology guidelines for management of gout[J]. Arthritis Care Res, 2012, 64(10):1431-1446.
5.	Hamburger M, Baraf HS, Adamson TC, et al. 2011 recommendations for the diagnosis and management of gout and hyperuricemia[J]. Phys Sportsmed, 2011, 39(4):98-123.
6.	Wallace SL, Robinson H, Masi AT, et al. Preliminary criteria for the classification of the acute arthritis of primary gout[J]. Arthritis Rheum, 1977, 20(3):895-900.
7.	Williamson A, Hoggart B. Pain:a review of three commonly used pain rating scales[J]. J Clin Nurs, 2005, 14(7):798-804.
8.	Wortmann RL, MacDonald PA, Hunt B, et al. Effect of prophylaxis on gout flares after the initiation of urate-lowering therapy:analysis of data from three phase Ⅲ trials[J]. Clin Ther, 2010, 32(14):2386-2397.
9.	Hainer BL, Matheson E, Wilkes RT, Diagnosis, treatment, and prevention of gout[J]. Am Fam Physician, 2014, 90(12):831-836.
10.	van Durme CM, Wechalekar MD, Buchbinder R, et al. Non-steroidal anti-inflammatory drugs for acute gout[J]. Cochrane Database Syst Rev, 2014, 16(9):CD010120.
11.	van Echteld I, Wechalekar MD, Schlesinger N, et al. Colchicine for acute gout[J]. Cochrane Database Syst Rev, 2014, 15(8):CD006190.
12.	Seminerio J, Mcgrath K, Arnold CA, et al. Medication-associated lesions of the GI tract[J]. Gastrointest Endosc, 2014, 79(1):140-150.
13.	Chen HW, Chen KC, Chen JS. Colchicine and NSAID combination causing acute kidney injury[J]. J Coll Physicians Surg Pak, 2012, 22(11):737-739.
14.	缪定国, 舒彬, 杨志金, 等. 依托芬那酯超声透入治疗网球肘疗效观察[J]. 中国康复, 2011, 26(1):73.
15.	冷晓梅, 曾小峰, 黄慈波, 等, 依托芬那酯凝胶治疗关节痛的多中心随机开放对照研究[J]. 中国新药杂志, 2010, 19(14):1241-1243.
16.	Matsumotok, Nambuk, Morinon, et al. Disposition and metabolism of[14C] etofenamate in rats[J]. Yakuri to Chiryo, 1982, 10(8):4409-4421.
17.	Dajani EZ, Islam K, Cardiovascular and gastrointestinal toxicity of selective cyclo-oxygenase-2 inhibitors in man[J]. J Physiol Pharmacol, 2008, 59 (Suppl 2):117-133.
18.	Nandakishore R, Yalavarthi PR, Kiran YR, et al. Selective cyclooxygenase inhibitors:current status[J]. Curr Drug Discov Technol, 2014, 11(2):127-32.
19.	Nerlekar N, Beale A, Harper RW. Colchicine--a short history of an ancient drug[J]. Med J Aust, 2014, 201(11):687-688.

1. Harris MD, Siegel LB, Alloway JA. Gout and hyperuricemia[J]. Am Fam Physician, 1999, 59(4):925-934.
2. Brook RA, Forsythe A, Smeeding JE, et al. Chronic gout:epidemiology, disease progression, treatment and disease burden[J]. Curr Med Res Opin, 2010, 26(12):2813-2821.
3. Doherty M, New insights into the epidemiology of gout[J]. Rheumatology, 2009, 48(Suppl 2):ii2-ii8.
4. Dinesh K, John DF, Puja PK, et al. 2012 American College of Rheumatology guidelines for management of gout[J]. Arthritis Care Res, 2012, 64(10):1431-1446.
5. Hamburger M, Baraf HS, Adamson TC, et al. 2011 recommendations for the diagnosis and management of gout and hyperuricemia[J]. Phys Sportsmed, 2011, 39(4):98-123.
6. Wallace SL, Robinson H, Masi AT, et al. Preliminary criteria for the classification of the acute arthritis of primary gout[J]. Arthritis Rheum, 1977, 20(3):895-900.
7. Williamson A, Hoggart B. Pain:a review of three commonly used pain rating scales[J]. J Clin Nurs, 2005, 14(7):798-804.
8. Wortmann RL, MacDonald PA, Hunt B, et al. Effect of prophylaxis on gout flares after the initiation of urate-lowering therapy:analysis of data from three phase Ⅲ trials[J]. Clin Ther, 2010, 32(14):2386-2397.
9. Hainer BL, Matheson E, Wilkes RT, Diagnosis, treatment, and prevention of gout[J]. Am Fam Physician, 2014, 90(12):831-836.
10. van Durme CM, Wechalekar MD, Buchbinder R, et al. Non-steroidal anti-inflammatory drugs for acute gout[J]. Cochrane Database Syst Rev, 2014, 16(9):CD010120.
11. van Echteld I, Wechalekar MD, Schlesinger N, et al. Colchicine for acute gout[J]. Cochrane Database Syst Rev, 2014, 15(8):CD006190.
12. Seminerio J, Mcgrath K, Arnold CA, et al. Medication-associated lesions of the GI tract[J]. Gastrointest Endosc, 2014, 79(1):140-150.
13. Chen HW, Chen KC, Chen JS. Colchicine and NSAID combination causing acute kidney injury[J]. J Coll Physicians Surg Pak, 2012, 22(11):737-739.
14. 缪定国, 舒彬, 杨志金, 等. 依托芬那酯超声透入治疗网球肘疗效观察[J]. 中国康复, 2011, 26(1):73.
15. 冷晓梅, 曾小峰, 黄慈波, 等, 依托芬那酯凝胶治疗关节痛的多中心随机开放对照研究[J]. 中国新药杂志, 2010, 19(14):1241-1243.
16. Matsumotok, Nambuk, Morinon, et al. Disposition and metabolism of[14C] etofenamate in rats[J]. Yakuri to Chiryo, 1982, 10(8):4409-4421.
17. Dajani EZ, Islam K, Cardiovascular and gastrointestinal toxicity of selective cyclo-oxygenase-2 inhibitors in man[J]. J Physiol Pharmacol, 2008, 59 (Suppl 2):117-133.
18. Nandakishore R, Yalavarthi PR, Kiran YR, et al. Selective cyclooxygenase inhibitors:current status[J]. Curr Drug Discov Technol, 2014, 11(2):127-32.
19. Nerlekar N, Beale A, Harper RW. Colchicine--a short history of an ancient drug[J]. Med J Aust, 2014, 201(11):687-688.

West China Medical Journal

Clinical Study on Colchicine Combined with Etofenamate Cream in the Treatment of Gout

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