ACR Meeting Abstracts

ACR Meeting Abstracts

Abstract Number: 1013

The Risk of Colchicine Associated Myopathy in Gout: Influence of Concomitant Use of Statin

Oh Chan Kwon1, Byeongzu Ghang2, Seokchan Hong3, Yong-Gil Kim4, Chang-Keun Lee3 and Bin Yoo4, 1Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, Korea, The Republic of, 2Division of Rheumatology, Department of Internal Medicine, Univerisy of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea, 3Division of Rheumatology, Department of Internal Medicine, University of Ulsan College of Medicine, Asan Medical Center, Seoul, South Korea, 4Division of Rheumatology, Department of Internal Medicine, University of Ulsan Collage of Medicine, Asan Medical Center, Seoul, South Korea

Meeting: 2016 ACR/ARHP Annual Meeting

Date of first publication: September 28, 2016

Keywords: , ,

Session Information

Date: Sunday, November 13, 2016

Title: Muscle Biology, Myositis and Myopathies

Session Type: ACR Concurrent Abstract Session

Session Time: 4:30PM-6:00PM

Background/Purpose: To investigate the risk of concomitant use of statin on the development of myopathy in gout patients who received colchicine.

Methods: We included patients with gout at a tertiary medical center in Korea from January 2000 to March 2016, who received colchicine with or without statin. Clinical characteristics including comorbidities such as hypertension, diabetes mellitus, chronic kidney disease, and liver cirrhosis were collected. Myopathy was defined as the presence of muscle symptoms with elevation of creatinine phosphokinase (CPK) and/or myoglobin. Multivariate Cox analysis was performed to identify risk factors of developing myopathy. And by combining inverse probability of treatment weighting (IPTW) to Cox analysis, we evaluated whether concomitant statin use was associated with increased myopathy.

Results: Of the total 674 patients with gout, 486 received colchicine alone and 188 received colchicine with statin. The rate of myopathy was not higher in patients who received colchicine with statin than in those who received colchicine alone (2.7% vs 1.4%, p=0.330). In multivariate Cox analysis, following factors were associated with increased risk of myopathy: chronic kidney disease (hazard ratio [HR] 29.056, 95% confidence interval [CI] 4.387-192.450, p<0.001), liver cirrhosis (HR 10.676, 95% CI 1.279-89.126, p=0.029), colchicine dose increment (HR 20.960, 95% CI 1.835-239.481, p=0.014) and concomitant CYP 3A4 inhibitor use (HR 12.027, 95% CI 2.743-52.725, p=0.001). Concomitant use of statin, however, was not associated with increased risk of developing myopathy even after adjusting for confounders using IPTW (Multivariate-adjusted HR 1.123 [95% CI 0.262-4.814, p=0.875] and IPTW adjusted HR 0.321 [95% CI 0.077-1.345, p=0.120]).

Conclusion: In patients with gout, concomitant use of colchicine with statin was not associated with increased risk of myopathy compared to use of colchicine alone. The increased risk of myopathy was significantly associated with the following variables: chronic kidney disease, liver cirrhosis, colchicine dose increment and CYP 3A4 inhibitor use. Thus, concomitant use of statin with colchicine seems to be safe from myotoxicity in patients with gout.

 

Table 1. Analysis of clinical factors associated with myopathy in gout patients who received colchicine  

Univariate analysis

 

Unadjusted hazard ratio

95% CI

p-value

Female

3.822

0.488-29.927

0.202

Age

1.043

0.995-1.094

0.078

Baseline creatinine

4.083

0.369-45.232

0.252

Colchicine dose

7.068

0.622-80.343

0.115

Hypertension

3.431

1.088-10.820

0.035

Diabetes mellitus

5.033

1.361-18.612

0.015

Chronic kidney disease

6.286

1.991-19.844

0.002

Coronary artery disease

8.816

2.641-29.435

0.000

Heart failure

4.475

0.979-20.461

0.053

Cerebrovascular event

4.057

0.522-31.522

0.181

Cancer

1.181

0.152-9.184

0.874

Fatty liver

1.009

0.130-7.855

0.993

Liver cirrhosis

7.015

0.905-54.379

0.062

Nephrotic syndrome

0.049

N/A

0.838

CYP 3A4 inducer

0.049

N/A

0.813

CYP 3A4 inhibitor

7.922

2.144-29.270

0.002

Statin

2.006

0.636-6.322

0.235

Multivariate analysis

 

Adjusted hazard ratio

95% CI

p-value

Chronic kidney disease

29.056

4.387-192.450

0.000

Liver cirrhosis

10.676

1.279-89.126

0.029

Colchicine dose

20.960

1.835-239.481

0.014

CYP 3A4 inhibitor

12.027

2.743-52.725

0.001

Statin

1.123

0.262-4.814

0.875

 

Disclosure: O. C. Kwon, None; B. Ghang, None; S. Hong, None; Y. G. Kim, None; C. K. Lee, None; B. Yoo, None.

To cite this abstract in AMA style:

Kwon OC, Ghang B, Hong S, Kim YG, Lee CK, Yoo B. The Risk of Colchicine Associated Myopathy in Gout: Influence of Concomitant Use of Statin [abstract]. Arthritis Rheumatol. 2016; 68 (suppl 10). https://acrabstracts.org/abstract/the-risk-of-colchicine-associated-myopathy-in-gout-influence-of-concomitant-use-of-statin/. Accessed .

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