Gout remission definition: Does colchicine offer an advantage?

Treatment with colchicine for 6 months when commencing urate-lowering therapy (ULT) provides no additional benefit in achieving gout remission regardless of the definition used, according to a study. 

The authors analysed data from a 12-month double-blind, placebo-controlled trial involving 200 individuals with gout who initiated allopurinol. Participants were randomized to receive prophylaxis with 0.5 mg daily colchicine or placebo for 6 months, followed by 6 months of additional follow-up. 

Gout remission was assessed using the 2016 preliminary definition or the simplified definition without patient-reported outcomes. In addition, the authors evaluated illness perceptions using a gout-specific version of the Brief Illness Perception Questionnaire. 

Few participants achieved remission in the first 6 months using either the 2016 preliminary definition (3 percent with colchicine vs 4 percent with placebo) or the simplified definition (7 percent with colchicine vs 12 percent with placebo). 

After treatment discontinuation, fewer participants who received colchicine versus placebo achieved remission in the next 6 months based on the 2016 preliminary definition (4 percent vs 14 percent; p=0.03) and the simplified definition (14 percent vs 28 percent; p=0.02). 

“Participants fulfilling remission using either definition had more favourable perceptions about their gout symptoms and illness concerns, as well as consequences, when using the simplified definition,” the authors said.