NEW ORLEANS - Colchicine is an effective steroid-sparing agent that can be used to treat refractory chronic idiopathic urticaria, based on data from a review of adults who received colchicine for CIU between 2003 and 2008.
Colchicine has been shown to decrease mast cell degranulation, suppress leukotriene generation, and decrease leukocyte adhesiveness and migration, said Dr. Mary S. Georgy of Northwestern University in Chicago and her associates.
To assess the agent's effectiveness in this setting, the investigators reviewed charts from 55 patients with CIU who were treated with colchicine for at least 7 days, focusing on the type of urticaria, type of response, and use of oral steroids before and after colchicine treatment.
Overall, 24 patients responded to colchicine, 2 partially responded, and 29 did not respond (44%, 4%, and 53%, respectively). The average number of steroid courses in the responders dropped significantly between the 6 months prior to and the 6 months after colchicine use (2.44 vs. 0.33). Information on the average number of steroid courses was available only for the responders. The study findings were presented in a poster at the annual meeting of the American Academy of Allergy, Asthma, and Immunology.
Response was defined as subjective improvement and a decrease in the oral steroid dosage of at least 50% within 3 months of beginning colchicine. A partial response was defined as a subjective improvement with no decrease in oral steroids by 50% within 3 months of beginning colchicine.
Skin biopsies from 27 patients, including 14 responders, 12 nonresponders, and 1 partial responder, showed neutrophilic urticaria in 86% of responders and in 25% of nonresponders.
"Colchicine was particularly effective in patients with neutrophilic urticaria," the researchers noted.
Overall, 10 responders, 5 nonresponders, and 1 partial responder (29% of the patients) reported gastrointestinal complaints, but the differences among the groups were not significant.
"Colchicine has a relatively safe profile in chronic idiopathic urticaria," the researchers noted.
Dr. Georgy had no financial conflicts to disclose.