tailieunhanh - Báo cáo y học: "Colchicine in acute gouty arthritis: the optimum dose"

Tuyển tập các báo cáo nghiên cứu về y học được đăng trên tạp chí y học General Psychiatry cung cấp cho các bạn kiến thức về ngành y đề tài: Colchicine in acute gouty arthritis: the optimum dose? | Available online http content 8 5 405 Letter Colchicine in acute gouty arthritis the optimum dose George I Varughese1 and Abraham I Varghese2 1 University Hospital of North Staffordshire Stoke-on-Trent ST4 8HZ UK 2Northampton General Hospital Northampton NN1 5BD UK Corresponding author GI Varughese georgeiv@ Published 19 September 2006 Arthritis Research Therapy 2006 8 405 doi ar2039 This article is online at http eontent 8 5 405 2006 BioMed Central Ltd See related review by Cronstein and Terkeltaub http content 8 S1 S3 We applaud Cronstein and Terkeltaub 1 on their comprehensive review of the inflammatory process of gout and its treatment. Although they allude to the fact that colchicine probably has the smallest therapeutic window of any drug used to treat acute gouty arthritis they have suggested In treating acute gouty arthritis colchicine is typically administered as an oral mg dose followed by mg at hourly intervals until gastrointestinal side effects . nausea vomiting or diarrhea occur or a maximum total of six to eight doses has been administered see also the recommended dosage in Table 1 in 1 . This is very similar to the dosage of colchicine suggested a decade ago 2 and indeed comparable to the regimen that was also expressed in grains in Hollander s Textbook of Rheumatology in 1960 3 . Despite the fact that there is perhaps only one double blind placebo controlled study on colchicine in acute gout where gastrointestinal side effects occurred before the relief of pain 1 and the optimal dose of colchicine still remains elusive there has not been any significant change to the recommended dosage in acute gout nearly half a century later 1 . The suggestion to administer colchicine at frequent intervals until the development of gastrointestinal side effects is a matter of significant concern 4 from a practical perspective in routine clinical practice. Of late

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