The relation of colchicine to total joint arthroplasty among people with gout in a population‐based cohort study

Objectives To evaluate the relation of colchicine use to the risk of total joint arthroplasty (TJA) in individuals with gout, the most common form of arthritis for which colchicine is prescribed. Methods This new‐user design, time‐stratified, population‐based cohort study utilized a UK primary care database (2000 to 2021). We identified participants with gout who were newly prescribed colchicine after their gout diagnosis. Each colchicine initiator was propensity score‐matched with a non‐initiator using one‐year cohort accrual blocks. The effect of colchicine on the risk of TJA was assessed using Cox proportional hazard regression. Analyses were repeated limited to participants with both gout and knee/hip osteoarthritis (OA). Results We identified 31,478 colchicine initiators who were propensity score‐matched to an equal number of non‐initiators (mean age 60, mean BMI 30), with a median follow‐up time of 4.5 years. Colchicine initiators had a 12% lower risk of TJA than non‐initiators (HR 0.88 95% CI 0.81 to 0.96), which remained similar after additional adjustment for confounders (HR 0.89 95% CI 0.82 to 0.97). Colchicine initiators with gout had a 23% lower risk of TJA in those with knee/hip OA (HR 0.77 95% CI 0.64 to 0.92) compared with non‐initiators (HR 0.77 95% CI 0.64 to 0.92). Conclusion In this large population‐based cohort of people with gout, colchicine initiation was associated with a modestly lower risk of TJA. Colchicine may offer a long‐term benefit in reducing the risk of joint arthroplasty in individuals with gout and knee or hip OA.