help button home button
AJRCCM
HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
This Article
Right arrow Full Text
Right arrow Full Text (PDF)
Right arrow Alert me when this article is cited
Right arrow Alert me if a correction is posted
Services
Right arrow Similar articles in this journal
Right arrow Similar articles in PubMed
Right arrow Alert me to new issues of the journal
Right arrow Download to citation manager
Right arrow reprints & permissions
Citing Articles
Right arrow Citing Articles via HighWire
Right arrow Citing Articles via Google Scholar
Google Scholar
Right arrow Articles by FISH, J. E.
Right arrow Articles by SZEFLER, S. J.
Right arrow Search for Related Content
PubMed
Right arrow PubMed Citation
Right arrow Articles by FISH, J. E.
Right arrow Articles by SZEFLER, S. J.

Am. J. Respir. Crit. Care Med., Volume 156, Number 4, October 1997, 1165-1171

An Evaluation of Colchicine as an Alternative to Inhaled Corticosteriods in Moderate Asthma

JAMES E. FISH, STEPHEN P. PETERS, CHRISTOPHER V. CHAMBERS, STEPHEN J. MCGEADY, KENNETH R. EPSTEIN, HOMER A. BOUSHEY, REUBEN M. CHERNIACK, VERNON M. CHINCHILLI, JEFFREY M. DRAZEN, JOHN V. FAHY, SUZANNE S. HURD, ELLIOT ISRAEL, STEPHEN C. LAZARUS, ROBERT F. LEMANSKE, RICHARD J. MARTIN, ELIZABETH A. MAUGER, CHRISTINE SORKNESS, and STANLEY J. SZEFLER

Thomas Jefferson University, Philadelphia, Pennsylvania; Brigham and Women's Hospital and Harvard Medical School, Boston, Massachusetts; the University of California at San Francisco, San Francisco, California; Milton S. Hershey Medical Center, Hershey, Pennsylvania; the University of Wisconsin, Madison, Wisconsin; the National Jewish Medical and Research Center, Denver, Colorado; and the National Heart, Lung, and Blood Institute, Bethesda, Maryland

Colchicine demonstrates an array of anti-inflammatory properties of potential relevance to asthma. However, the efficacy of colchicine as an alternative to inhaled corticosteroid therapy for asthma is unknown. Five centers participated in a controlled trial testing the hypothesis that in patients with moderate asthma needing inhaled corticosteroids for control, colchicine provides therapeutic benefit as measured by maintenance of control when inhaled steroids are discontinued. Subjects were stabilized on triamcinolane acetonide (800 µg daily) and then enrolled in a 2-wk run-in during which all subjects took both colchicine (0.6 mg/twice a day) and triamcinolone. At the end of the run-in, all subjects discontinued triamcinolone and were randomized to continued colchicine (n = 35) or placebo (n = 36) for a 6-wk double-blind treatment period. The treatment groups were similar in terms of disease severity. After corticosteroid withdrawal, 60% of colchicine-treated and 56% of placebo-treated subjects were considered treatment failures as defined by preset criteria. No significant difference in survival curves was found between treatment groups (log rank = 0.38). Other measures, including changes in FEV1, peak expiratory flow, symptoms, rescue albuterol use, and quality of life scores, also did not differ between groups. Of note, subjects failing treatment had significantly greater methacholine responsiveness at baseline than did survivors (PC20, 0.81 ± 1.38 versus 2.11 ± 2.74 mg/ml; p = 0.01). An analysis of treatment failures suggested that the criteria selected for failure reflected a clinically meaningful but safe level of deterioration. We conclude that colchicine is no better than placebo as an alternative to inhaled corticosteroids in patients with moderate asthma. Additionally, we conclude that the use of treatment failure as the primary outcome variable in an asthma clinical trial where treatment is withdrawn is feasible and safe under carefully monitored conditions.




This article has been cited by other articles:


Home page
 NEJMHome page
The American Lung Association Asthma Clinical Rese
Randomized Comparison of Strategies for Reducing Treatment in Mild Persistent Asthma
N. Engl. J. Med., May 17, 2007; 356(20): 2027 - 2039.
[Abstract] [Full Text] [PDF]

Home page
 Ann Rheum DisHome page
C Sackesen, A Bakkaloglu, B E Sekerel, F Ozaltin, N Besbas, E Yilmaz, G Adalioglu, and S Ozen
Decreased prevalence of atopy in paediatric patients with familial Mediterranean fever
Ann Rheum Dis, February 1, 2004; 63(2): 187 - 190.
[Abstract] [Full Text] [PDF]

Home page
 ChestHome page
M. Kraft, R. J. Martin, S. C. Lazarus, J. V. Fahy, H. A. Boushey, R. F. Lemanske Jr., and S. J. Szefler
Airway Tissue Mast Cells in Persistent Asthma: Predictor of Treatment Failure When Patients Discontinue Inhaled Corticosteroids
Chest, July 1, 2003; 124(1): 42 - 50.
[Abstract] [Full Text] [PDF]

Home page
 JAMAHome page
R. F. Lemanske Jr, C. A. Sorkness, E. A. Mauger, S. C. Lazarus, H. A. Boushey, J. V. Fahy, J. M. Drazen, V. M. Chinchilli, T. Craig, J. E. Fish, et al.
Inhaled Corticosteroid Reduction and Elimination in Patients With Persistent Asthma Receiving Salmeterol: A Randomized Controlled Trial
JAMA, May 23, 2001; 285(20): 2594 - 2603.
[Abstract] [Full Text] [PDF]

Home page
 Am. J. Respir. Crit. Care Med.Home page
J. V. FAHY, H. A. BOUSHEY, S. C. LAZARUS, E. A. MAUGER, R. M. CHERNIACK, V. M. CHINCHILLI, T. J. CRAIG, J. M. DRAZEN, J. G. FORD, J. E. FISH, et al.
Safety and Reproducibility of Sputum Induction in Asthmatic Subjects in a Multicenter Study
Am. J. Respir. Crit. Care Med., May 1, 2001; 163(6): 1470 - 1475.
[Abstract] [Full Text]

Home page
 ChestHome page
F. T. Leone, E. A. Mauger, S. P. Peters, V. M. Chinchilli, J. E. Fish, H. A. Boushey, R. M. Cherniack, J. M. Drazen, J. V. Fahy, J. Ford, et al.
The Utility of Peak Flow, Symptom Scores, and {beta}-Agonist Use as Outcome Measures in Asthma Clinical Research
Chest, April 1, 2001; 119(4): 1027 - 1033.
[Abstract] [Full Text] [PDF]


HOME HELP FEEDBACK SUBSCRIPTIONS ARCHIVE SEARCH TABLE OF CONTENTS
Proc. Am. Thorac. Soc. Am. J. Respir. Cell Mol. Biol.
Copyright © 1997 American Thoracic Society 		  ATS 2008 State of the Art Course