Session Information
Session Type: Abstract Submissions (ACR)
Background/Purpose Colchicine is a commonly used medication, sometime associated with bone marrow toxicity. The objective of this study was to examine the risk of severe hematologic side effects including pancytopenia and aplastic anemia with colchicine.
Methods This retrospective study utilized the Veterans Affairs (VA) administrative and clinical databases from fiscal year 2001 to 2012. Colchicine use was defined as at least 30-day filled prescription. Prevalent gout was defined as the presence of >=1 International classification of diseases, ninth revision (ICD-9) codes for gout during an inpatient visit or during ³2 codes during outpatient visits. Aplastic anemia was captured with an ICD-9 code of 284.9 and Pancytopenia with a code of 284.1. We used Cox proportional hazards models that assessed hazards of aplastic anemia or pancytopenia adjusted for the following factors: Model 1: drug exposure, age, gender, body mass index, race, marital status, region; Model 2: variables in model 1, plus baseline Charlson comorbidities.
Results 198 gout patients had aplastic anemia, of which 59 occurred in patients exposed to colchicine. 2047 gout patients had pancytopenia, of which 582 occurred in patients exposed to colchicine. The incidence rate of aplastic anemia was 0.5/1000 person years and of pancytopenia was xx/ in patients taking colchicine.
Conclusion Colchicine increases the risk of aplastic anemia 3-4 fold and pancytopenia 2-3 fold in gout patients. Predictive models that can identify coexisting conditions that increase the risk of these side effects need to be developed to screen out patients at high-risk of these severe hematologic side effects.
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Table 1. Association of colchicine with severe hematologic side effects |
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Model 1 (demographics) |
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Model 2 (demographics + comorbidity) |
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Hazard ratio (95% CI) |
p-value |
Hazard ratio (95% CI) |
p-value |
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Aplastic anemia |
3.72 (2.61, 5.31) |
<0.0001 |
3.32 (2.32, 4.76) |
<0.0001 |
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Pancytopenia |
2.88 (2.58, 3.22) |
<0.0001 |
2.26 (2.02, 2.53) |
<0.0001 |
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Disclosure:
J. A. Singh,
Savient,
2,
Takeda,
2,
Degeneron,
5,
Allergan ,
5;
S. Yang,
None;
J. Foster,
None.
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ACR Meeting Abstracts - https://acrabstracts.org/abstract/the-risk-of-aplastic-anemia-and-pancytopenia-with-colchicine-a-retrospective-study-of-integrated-health-system-database/